Series 10, Number 226 July 2005

Health Status of

Non-Hispanic U.S.-Born

and Foreign-Born Black

and White Persons:

United States, 1992–95
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Suggested citation

Lucas JW, Barr-Anderson DJ, Kington RS. Health status of non-Hispanic

U.S.-born and foreign-born black and white persons: United States, 1992–95.

National Center for Health Statistics. Vital Health Stat 10(226). 2005.

Library of Congress Catalog Number 362.1’0973’021 s—dc21

For sale by the U.S. Government Printing Office

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Printed on acid-free paper.
Series 10, Number 226

Health Status of

Non-Hispanic U.S.-Born

and Foreign-Born Black

and White Persons:

United States, 1992–95

Data From the National Health

Interview Survey

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Hyattsville, Maryland

July 2005

DHHS Publication No. (PHS) 2005-1554
National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

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

Michael H. Sadagursky, Acting Co-Deputy Director

Jennifer H. Madans, Ph.D., Associate Director for Science

Edward L. Hunter, Associate Director for Planning, Budget,

and Legislation

Michael H. Sadagursky, Associate Director for

Management and Operations

Lawrence H. Cox, Ph.D., Associate Director for Research

and Methodology

Margot A. Palmer, Director for Information Technology

Margot A. Palmer, Acting Director for Information Services

Linda T. Bilheimer, Ph.D., Associate Director for Analysis

Epidemiology, and Health Promotion

Charles J. Rothwell, Director for Vital Statistics

Jane E. Sisk, Ph.D., Director for Health Care Statistics

Jane F. Gentleman, Ph.D., Director for Health Interview

Statistics

Clifford L. Johnson, Director for Health and Nutrition

Examination Surveys

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director

Anne K. Stratton, M.S., Deputy Director

Eve Powell-Griner, Ph.D., Acting Associate Director for

Science

Susan S. Jack, M.S., Special Assistant for Data Quality and

User Services

Marcie L. Cynamon, M.A., Chief, Survey Planning and

Special Surveys Branch

Eve Powell-Griner, Ph.D., Chief, Data Analysis and Quality

Assurance Branch

Anne K. Stratton, M.S., Acting Chief, Data Production and

Systems Branch
Contents

Abstract .................................................................................................. 1

Introduction ............................................................................................... 1

Methods .................................................................................................. 2

Results ................................................................................................... 3

Demographic Characteristics................................................................................ 3

Health Characteristics ..................................................................................... 4

Discussion ................................................................................................ 6

Recommendations for Future Research ....................................................................... 7

Conclusion ................................................................................................ 7

References ............................................................................................... 8

Appendix I............................................................................................... 15

Technical Notes on Methods............................................................................... 15

Appendix II .............................................................................................. 16

Definition of Terms ..................................................................................... 16

Appendix III ............................................................................................. 18

Tables of Unadjusted Estimates for Selected Health Outcomes .................................................. 18

Figures

1. Age-adjusted respondent-assessed health status, by race and nativity: United States, 1992–95....................... 4

2. Age-adjusted smoking status, by race and nativity for women 18 years and over: United States, 1992–95............. 5

3. Age-adjusted self-reported AIDS knowledge, by race and nativity for adults 18 years and over: United States,

1992–95 ........................................................................................... 6

Detailed Tables

1. Number of persons and percent distribution of non-Hispanic U.S.- and foreign-born, by race: National Health Interview

Survey, average annual figures, 1992–95 ................................................................ 10

2. Percent distributions of selected demographic characteristics (with standard errors), by race and nativity: United States,

average annual figures, 1992–95 ....................................................................... 10

3. Age-adjusted percent distributions of selected health characteristics (with standard errors), by race and nativity:

United States, average annual figures, 1992–95 ........................................................... 12

4. Age-adjusted mean number of physician contacts and restricted activity days per year (with standard errors), by race

and nativity: United States, average annual figures, 1992–95 ................................................ 12

5. Number of persons, hospital stays, and days of hospitalization and age-adjusted percent distribution of number of

hospital stays (with standard errors), by race and nativity: United States, average annual figures, 1992–95 ........... 13

6. Age-adjusted percent distributions of smoking status (with standard errors), by sex, race and nativity: United States,

average annual figures, 1992–95 ....................................................................... 13

7. Age-adjusted percent distributions of AIDS knowledge, testing, and perceived risk (with standard errors), by race and

nativity: United States, average annual figures, 1992–95 ................................................... 14

iii
Appendix Tables

I. Response rate, number of persons, and number of households interviewed for the core questionnaire and selected

supplements: National Health Interview Survey, 1992–95 ................................................... 15

II. Unadjusted percent distributions of selected health characteristics (with standard errors), by race and nativity:

United States, average annual figures 1992–95 ........................................................... 18

III. Unadjusted mean number of physician contacts and restricted activity days per year (with standard errors), by race

and nativity: United States, average annual figures, 1992–95 ................................................ 19

IV. Number of persons, hospital stays, and days of hospitalization, and unadjusted percent distribution of number of

hospital stays (with standard errors), by race and nativity: United States, average annual figures, 1992–95 ........... 19

V. Unadjusted percent distribution of smoking status (with standard errors), by race and nativity: United States, average

annual figures, 1992–95 .............................................................................. 19

VI. Unadjusted percent distributions of AIDS knowledge, testing, and perceived risk (with standard errors), by race and

nativity: United States, average annual figures, 1992–95 ................................................... 20

iv
Objective

This report describes differences in

selected sociodemographic and health

characteristics of the non-Hispanic U.S.

population by race (black and white)

and nativity (U.S-born and foreignborn), using data from the 1992–95

National Health Interview Surveys

(NHIS).

Methods

Data were collected for a household,

multistage probability sample

representative of the U.S. civilian

noninstitutionalized population. A total

of 456,729 persons were included in

these analyses for the 4 data years

combined. Statistics were age adjusted

to the 2000 U.S. standard population,

and unadjusted estimates are also

presented for comparison.

Results

Over 67 percent of the foreign-born

black population assessed their health

as being excellent or very good,

significantly higher than U.S.-born black

persons (52 percent), and similar to

U.S.- and foreign-born white persons

(69 percent for each group). Eleven

percent of foreign-born black persons

were limited in performing some type of

activity, compared with 20 percent of

their U.S.-born counterparts. Among

white persons, 14 percent of foreignborn and 16 percent of U.S.-born

individuals were limited in activity. The

foreign-born black population,

especially women, had the lowest

current smoking prevalence of all of the

study groups.

Conclusions

The data show significant differences

in health characteristics between

groups classified by race and nativity.

Information about the nativity status of

black and white populations may be

useful in public health efforts to

eliminate health disparities.

Keywords: Foreign-born c race c

National Health Interview Survey c

activity limitation c smoking c AIDS

knowledge

Health Status of Non-Hispanic

U.S.-Born and Foreign-Born

Black and White Persons:

United States, 1992–95

By Jacqueline W. Lucas, M.P.H., Division of Health Interview

Statistics, National Center for Health Statistics; Daheia J. BarrAnderson, M.S.P.H., Department of Kinesiology, University of

Maryland, and Raynard S. Kington, M.D., Ph.D., National Institutes

of Health

Introduction

According to the 2000 Census of

the United States, the immigrant

population increased by more

than 50 percent in the preceding decade

(1,2). Foreign-born individuals now

comprise approximately 11 percent of

the U.S. population (2), the largest

proportion since the early 1900s (3).

The majority of immigrants to the

United States are of Hispanic origin, and

substantial research has been done on

the health of U.S.-born Hispanic

Americans (4–7). Other public health

studies have focused on non-Hispanic

immigrant groups, such as immigrant

Asian Americans (8–11), but fewer

studies have focused on black

immigrants from Africa and the

Caribbean (12), or white immigrants of

non-Hispanic origin (13). In order to

focus on groups that have not been well

studied previously, this report is limited

to non-Hispanic black and non-Hispanic

white U.S.- and foreign-born persons.

Non-Hispanic foreign-born persons

represent a substantial proportion of

both the black and white population

groups. In 2000, 6.1 percent of the black

population was foreign-born, and

6.3 percent of the white population was

foreign-born (14). These numbers

represent an increase in both populations

from previous Census years—in 1980,

foreign-born persons made up

3.1 percent of the black population, and

4.9 percent of the white population (15).

The growth in the number of

non-Hispanic black immigrants and

non-Hispanic white immigrants has

important implications for the overall

health of this country’s population. The

health status, health behaviors, and

socioeconomic status of these two

immigrant groups may differ

substantially from one another, from

other ethnic immigrant groups, and from

their U.S.-born counterparts.

Previous research has shown that

foreign-born persons living in the

United States differ from native-born

persons with respect to

sociodemographic characteristics that are

correlates of health status. Foreign-born

persons are more likely to be older and

male (3), to live in urban areas, and to

have larger immediate families than

U.S.-born persons (16). Immigrants are

less likely to have completed high

school, but just as likely to complete

college as the native-born population.

Foreign-born persons are also more

likely to be unemployed, to earn less,

and to live in poverty than native-born

persons (3,17). The foreign-born

population is also more geographically

concentrated in the West and

Northeastern parts of the United States

than the native-born population (16).

The health patterns seen among

recent immigrants must be viewed

within the context of the history of

Page 1
Page 2 [ Series 10, No. 226

immigration to the United States. The

country or region of origin of specific

immigrant groups may be especially

important for understanding health

patterns because different countries

display widely varying levels of disease

exposure, health-related characteristics,

and health practices. Most U.S.-born

black Americans are the descendants of

slaves who were brought to the United

States in the 17th to early 19th

centuries, supplemented by a small flow

of voluntary black immigration to the

United States from the Caribbean that

began in the late 19th century. The

stream of black immigrants increased

with the elimination of the U.S.

immigration quota system in 1965 (18)

and passage of the Immigration Act of

1990, which introduced the diversity

visa program and an increased number

of employment visas (19). Currently, the

majority of new black immigrants to the

United States are from the Caribbean

(20,21), mainly Jamaica, Trinidad and

Tobago, Guyana, and Barbados (22).

Additionally, a growing minority of

black immigrants come from Africa,

primarily from Nigeria, Sudan, and

Ethiopia (12,23).

The countries of origin for white

immigrants have changed over time.

During the 17th and 18th centuries,

most of America’s immigrants came

from northern and western Europe,

primarily Great Britain and Ireland (17).

During the early 19th century, southern

and eastern Europeans began coming to

America in increasing numbers. While

western Europe continues to produce a

significant number of white immigrants

to the United States, in recent years a

significant number of white immigrants

have come from the former nations of

the Soviet Union, such as Russia,

Latvia, Estonia, and Lithuania.

Germany, France, and the United

Kingdom also continue to be sources of

non-Hispanic white immigrants to the

United States (24).

Immigrants constitute a diverse

group in American society with their

assorted immigration experiences,

customs, and traditions. It is important

to study the health patterns of both

black and white immigrants to provide a

richer understanding of how health

status varies by race, ethnicity, and

socioeconomic status in the United

States. In this report, we use one of the

few available large, nationally

representative health data sets to

describe the patterns of health status

among foreign-born non-Hispanic black

and white populations in the United

States, and compare them to each other

and to their U.S.-born counterparts.

Methods

This is the last of three reports

describing the health of racial and

ethnic subpopulations in the

United States. Earlier reports examined

the health status of Asian American and

Hispanic subgroups (4,9). For this

report, data from the 1992–95 National

Health Interview Survey (NHIS) were

used to describe the health of

non-Hispanic black and non-Hispanic

white U.S. immigrants and their

native-born counterparts. To facilitate

comparison to the earlier reports, this

report uses the same variables and

tabulation formats, and covers the same

data years (1992–95) as the report on

the Hispanic population groups. It is

useful to examine older years of data for

this report because little research has

been published comparing the health

status of native and immigrant black and

white populations in the United States.

Additional research on these populations

using more current NHIS data has

recently been published (25), and more

research is underway. Comparing the

results from this study to those of

analyses of more recent NHIS data will

be beneficial for observing trends.

For each year included in these

analyses (1992–95), the NHIS collected

data on a wide variety of health topics

and general health status measures from

approximately 127,000 persons in about

49,000 households. These data were

collected from nationally representative

samples of the civilian,

noninstitutionalized population of the

United States; and they have been

widely used to monitor trends in illness

and disability and to track progress

toward achieving national health

objectives. In 1992–95, the NHIS

consisted of two parts: (1) the core

questionnaire—a set of basic health and

demographic items; and (2) the

supplements—one or more sets of

questions on current health topics. The

core questionnaire remained the same

from 1992 to 1995 and collected data on

health status and health care utilization,

such as hospital visits, physician

contacts, restricted activity days, and

perceived health status. The supplements

changed from year to year depending on

data needs and current research topics of

interest; they covered such issues as

health insurance, immunization,

smoking, and AIDS knowledge and

attitudes.

For this report, data were analyzed

from the 1992–95 core NHIS

questionnaires (all demographic data,

activity limitation, hospital stays,

physician contacts, respondent-assessed

health status), the 1992–95 AIDS

knowledge and attitudes supplements

(self-reported knowledge of HIV/AIDS,

ever tested for HIV, perceived risk of

getting HIV), and the 1992 cancer

epidemiology supplement combined

with the 1993–95 Year 2000 Objectives

supplements (smoking and tobacco use).

Four years of data were aggregated to

increase the sample size of the

populations and increase the reliability

of the estimates of the health indicators.

To account for the complex, multistage

sample design of the NHIS, SUDAAN

software was used to produce the point

estimates and standard errors (26).

For this report, we limited the

analyses to non-Hispanic black and

white immigrants, and for comparative

purposes, their U.S.-born non-Hispanic

counterparts. Our results are therefore

generalizable only to these populations.

The sizes and the percent distributions

of the populations are shown in table 1.

On average, during the period 1992–95,

there were about 1.5 million black

immigrants and 6.8 million white

immigrants living in the United States.

Black immigrants comprised about

4.9 percent of the non-Hispanic black

population, and white immigrants

comprised about 3.7 percent of the

non-Hispanic white population.

The demographic characteristics in

the analyses include sex, age, education,

employment status, family income,

poverty status, family size, geographic
Series 10, No. 226 [ Page 3

region, place of residence, and duration

of residence in the United States. For

these analyses, persons born in a U.S.

territory were considered U.S.-born. The

health indicators examined include

respondent-assessed health status,

activity limitation, interval since last

physician contact, number of physician

contacts, restricted activity days,

hospital stays, days of hospitalization,

smoking status, self-reported AIDS

knowledge, HIV testing, and perceived

risk of acquiring the AIDS virus. The

time frame for the occurrences of

physician contacts, restricted activity

days, hospital stays, and days of

hospitalization was the last year before

interview. All variables are defined in

the ‘‘Technical Notes’’ at the end of this

report.

Age-adjusted estimates are

presented for all data in this report,

standardized to the 2000 U.S. population

(27). The age-adjusted estimates are

presented because foreign-born and

U.S.-born populations differ

substantially with respect to age

composition, which can confound

differences in health characteristics. The

unadjusted estimates for selected tables

and health outcomes are included in

‘‘Appendix I’’ of this report for the

reader’s reference and are not discussed

in the body of the report.

Standard errors are shown for all

percentages in the tables but not for the

frequencies. Unknown responses from

these analyses are excluded for all

variables except family income and

poverty status. The detailed family

income variable had a substantial

proportion of unknown data (15–

18 percent of data unknown for all data

years) due to the reluctance of some

survey participants to disclose

information about their annual income.

Since family income was used to

calculate poverty status, it also

contained a substantial proportion of

unknown data. Unknown responses were

very low (5 percent or less) for all other

variables included in this study.

Estimates with relative standard

errors of greater than 30 percent are

considered unreliable and are indicated

with an asterisk. The statistical

significance of differences between

point estimates was evaluated using

two-sided t-tests at the 0.05 level and

assuming independence. Terms such as

‘‘greater than,’’ ‘‘less than,’’ ‘‘more

likely,’’ ‘‘less likely,’’ ‘‘compared with,’’

or ‘‘opposed to’’ indicate a statistically

significant difference between estimates,

whereas ‘‘similar,’’ ‘‘no difference,’’ or

‘‘comparable’’ indicate that the estimates

are not statistically different. A lack of

commentary about any two estimates

should not be interpreted to mean that

the difference was found to be not

significant. In addition, these data were

not adjusted for multiple comparisons.

Refer to the ‘‘Technical Notes’’ for

further information.

Results

The results are presented in two

sections. The ‘‘Demographic

Characteristics’’ section describes

the black and white foreign-born and

U.S.-born populations with respect to

selected social, economic, and

demographic characteristics that are

often associated with health (table 2).

The ‘‘Health Characteristics’’ section

describes differences among the same

groups with respect to health status,

health care, and health-related behaviors

(tables 3–7).

For reasons discussed in the

‘‘Introduction,’’ this analysis does not

include persons of Hispanic origin.

While that exclusion is not always

mentioned in the presentation of results,

it should be understood to apply

throughout the report. The presentation

of results emphasizes comparisons of

foreign-born and U.S.-born persons of

the same race.

Demographic

Characteristics

Table 2 presents demographic

characteristics of non-Hispanic black

and non-Hispanic white immigrants and

their U.S.-born counterparts.

Age

For both the black and white

populations, the mean age of the

immigrant population was greater than

the mean age of the native population

(35.6 years compared with 29.9 years

for the black population and 46.4 years

compared with 36.4 years for the white

population). Compared with the

U.S.-born black population, the black

immigrant population had a smaller

percentage of children (persons under

18) and elderly persons (persons aged

65 and over). More than one-half of

black immigrants were in the age group

25–44 years, compared with less than

one-third of U.S.-born black persons.

Compared with the U.S.-born white

population, the white immigrant

population had a smaller percentage of

children and a larger percentage of

persons in all other age groups. Of

foreign-born white persons, 22.6 percent

were 65 years of age or over, whereas

only 13.8 percent of U.S.-born white

persons were 65 or over.

Education

On average, black immigrants had

higher levels of educational attainment

than U.S.-born black persons:

17.3 percent of black immigrants had

completed college compared with

10.8 percent of U.S.-born black persons.

The white immigrant population had a

higher percentage of persons with less

than a high school education but also

had a higher percentage of college

graduates than U.S.-born white persons:

34.0 percent of white immigrants

compared with 32.5 percent of U.S.-born

white persons had not completed high

school, and 24.1 percent of white

immigrants compared with 18.7 percent

of U.S.-born white persons had

completed college.

Employment Status

Black immigrants were more likely

than U.S.-born black persons to be

currently employed (64.5 percent

compared with 57.1 percent).

Conversely, white immigrants were less

likely than their U.S.-born counterparts

to be currently employed (61.2 percent

and 66.3 percent, respectively).

Income and Poverty Status

Black immigrants were more likely

than U.S.-born black persons to have an
Page 4 [ Series 10, No. 226

annual family income of $35,000 or

more and less likely to have an income

below the poverty level. White

immigrants were less likely than

U.S.-born white persons to have an

annual family income of $35,000 or

more and more likely to have an income

below the poverty level. Nativity

differences in income and poverty were

smaller among white persons than

among black persons.

Family Size

Black immigrants were more likely

than U.S.-born black persons to live in

large families: 15.6 percent of black

immigrants lived in families with six or

more persons compared with

10.9 percent of U.S.-born black persons

who lived in families of that size. There

was no significant difference in family

size for foreign-born and U.S.-born

white persons.

Geographic Region

Most (52.5 percent) foreign-born

black persons lived in the Northeast

region of the United States, whereas

most (56.2 percent) U.S.-born black

persons lived in the South. Although the

white population groups were more

evenly distributed, the greatest

concentration of white immigrants was

also in the Northeast (31.2 percent), and

the greatest concentration of U.S.-born

white persons was also in the South

(32.3 percent).

Place of Residence

Immigrants were much more likely

than native-born persons to live in

nonmetropolitan statistical areas (MSA)

areas. Comparable proportions of

foreign- and U.S.-born black persons

lived in the central cities of MSAs, but

black immigrants were more likely to

live outside of central cities in MSAs

(40.4 percent and 27.9 percent,

respectively) than black native-born

persons. White immigrants were more

likely to live in the central cities of

MSAs than their U.S.-born counterparts

(35.8 percent and 22.4 percent,

respectively), but equally likely to live

outside of central cities in metropolitan

areas.

Years in the United States

Compared with white immigrants,

black immigrants were much less likely

to have been in the United States for 15

years or more (37.6 percent of black

immigrants and 50.6 percent of white

immigrants). Black immigrants were

more likely than white immigrants to

have been in the United States for 5–14

years (39.0 percent and 24.0 percent,

respectively). Similar proportions of

white and black immigrants had lived in

the United States for less than 5 years.

Health Characteristics

Table 3 provides data on

respondent-assessed health status,

activity limitation, and interval since last

physician contact.

Respondent-Assessed Health

Status

Figure 1 provides a comparison of

self-assessed health status for U.S.-born

and foreign-born black and white

persons. Nearly 38 percent of black

immigrants reported being in

‘‘excellent’’ health, compared with

27.5 percent of U.S.-born black persons;

and black immigrants were also more

likely than U.S.-born black persons to

report being in ‘‘very good’’ health.

Foreign-born white persons and

U.S.-born white persons reported similar

levels of ‘‘very good’’ or ‘‘excellent’’

health. The percent of black immigrants

with fair or poor health was about

one-half that of black U.S.-born persons;

but little difference in fair or poor health

was seen between the foreign-born and

U.S.-born white populations.

Activity Limitation Status

Black immigrants were less likely

than U.S.-born black persons to have a

health-related limitation of activity

(11.4 percent compared with

20.0 percent). White immigrants were

also less likely than U.S.-born white

persons to have an activity limitation

(13.6 percent vs. 15.5 percent).

Interval Since Last Physician

Contact

Although a larger proportion of

U.S.-born black persons were in fair or

poor health than their foreign-born

counterparts, there was little difference

between foreign-born and U.S.-born

black persons with respect to the

interval since the most recent contact

with a physician. Conversely, although

similar proportions of foreign-born and

Figure 1. Age-adjusted respondent-assessed health status, by race and nativity:

United States, 1992–95
Series 10, No. 226 [ Page 5

U.S.-born white persons had excellent or

very good health, U.S.-born white

persons were more likely to have been

in contact with a physician in the last

year than their foreign-born

counterparts. Table 4 shows data on the

mean number of physician contacts and

the mean number of restricted activity

days per year.

Physician Contacts

Black immigrants had a lower

average number of physician contacts in

the year prior to the interview than

U.S.-born black persons (5.0 percent vs.

6.2 percent), and white immigrants had a

lower average number of physician

contacts in the year prior to the

interview than U.S.-born white persons

(5.6 percent vs. 6.4 percent).

Restricted Activity Days

Foreign-born black persons had

fewer restricted activity days in the year

prior to the interview than U.S.-born

black persons (11.7 days vs. 22.4 days);

however, the average number of

restricted activity days in the year prior

to the interview was similar for foreignand U.S.-born white persons.

Hospital Stays

Table 5 provides data on the

number of days of hospitalization and

hospital stays. A smaller proportion of

foreign-born persons were hospitalized

in the year before interview than their

U.S.-born counterparts: 5.3 percent of

foreign-born black persons compared

with 7.8 percent of U.S.-born black

persons, and 5.6 percent of foreign-born

white persons compared with 6.6 percent

of U.S.-born white persons.

Smoking Status

Table 6 presents data on smoking

status by sex. The foreign-born adult

populations were less likely to be

current smokers than their U.S.-born

counterparts (11.1 percent of foreignborn black adults compared with

27.9 percent of U.S.-born black adults;

and 22.5 percent of foreign-born white

adults compared with 26.3 percent of

U.S.-born white adults). The ageFigure 2. Age-adjusted smoking status, by race and nativity for women 18 years and over:

United States, 1992–95

adjusted data by sex show that men

were more likely to be current smokers

than women of the same race and

nativity. Foreign-born black men were

less likely to be current smokers

(17.7 percent) than U.S.-born black men

(32.9 percent), but there was no

significant difference in current smoking

status between foreign- and U.S.-born

white men. Differences in smoking

status among the U.S.- and foreign-born

populations were more striking for

women, as shown in figure 2.

Foreign-born black women were much

less likely to be current smokers than all

other groups of women. Foreign-born

women were more likely than U.S.-born

women to never have smoked; this

difference was especially noticeable for

foreign-born black women, as nearly

90 percent of foreign-born black women

reported never having smoked. Table 7

shows data on AIDS knowledge, testing,

and the perceived risk of getting the

AIDS virus.

Self-Reported AIDS Knowledge

The foreign- and U.S.-born black

populations had similar proportions of

persons with ‘‘a lot’’ of AIDS

knowledge (32.7 percent and

29.1 percent, respectively). Foreign- and

U.S.-born white persons also had similar

proportions reporting ‘‘a lot’’ of

knowledge (33.1 percent and

32.1 percent, respectively). Figure 3

compares self-reported AIDS knowledge

for the four study groups. It shows that

native-born black persons were more

likely to know ‘‘nothing’’ about AIDS

than foreign-born persons, while the

opposite was true for the white

population.

Testing for AIDS Virus

Infection

Similar proportions of foreign- and

U.S.-born black persons had been tested

for the AIDS virus (32.7 percent and

33.4 percent, respectively). However,

white immigrants were more likely than

U.S.-born white persons to have been

tested (27.0 percent and 20.8 percent,

respectively).

Perceived Risk of Acquiring the

AIDS Virus

Among both black and white

persons, there was no significant

difference between foreign- and

U.S.-born populations in the proportions

who perceived a high or medium risk of

infection; however, black persons were

more likely to perceive themselves at
Page 6 [ Series 10, No. 226

Figure 3. Age adjusted self-reported AIDS knowledge, by race and nativity for adults 18

years and over: United States, 1992–95

high or medium risk than were white

persons, regardless of nativity.

Discussion

This report highlights selected

sociodemographic and health

characteristics of non-Hispanic

black and white immigrants and

U.S.-born persons. Consistent with

previous studies that analyzed regional

or national data on cancer,

cardiovascular disease, birth weight, and

maternal health behaviors for U.S.- and

foreign-born black persons and

U.S.-born white persons (28–36), this

study finds that foreign-born nonHispanic black persons are in better

health than U.S.-born non-Hispanic

black persons; in fact, the health status

of foreign-born non-Hispanic black

persons is similar to that of U.S.-born

non-Hispanic white persons. This study

also shows that, in most cases,

non-Hispanic white immigrants enjoy

similar health advantages over their

U.S.-born counterparts, a finding that is

consistent with mortality studies that

examined differentials between U.S.­

and foreign-born non-Hispanic white

groups (37–39). However, the

differences between U.S.-born and

foreign-born non-Hispanic white persons

were often smaller than the differences

between U.S.-born and foreign-born

non-Hispanic black persons. This may

be attributable to the fact that the

majority of foreign-born white

immigrants have reported having lived

in the United States for 15 years or

more (table 2). Previous studies have

shown that foreign-born persons who

have lived in the United States for a

considerable length of time lose some of

the advantages of being foreign-born

over the long term due to acculturation

(39).

Important sociodemographic

differences between foreign- and

U.S.-born non-Hispanic black persons

were found, as well as between foreignand U.S.-born non-Hispanic white

persons. In general, the immigrant

subpopulations had smaller percentages

of children and youth than the

populations of their U.S.-born

counterparts. In addition, the foreignborn non-Hispanic white population had

a relatively large proportion of elderly

persons. Foreign-born non-Hispanic

black persons had higher levels of

education than U.S.-born non-Hispanic

black persons, and had educational

levels that were similar to U.S.-born

non-Hispanic white persons. A similar

pattern was found among non-Hispanic

white immigrants and U.S.-born white

persons: foreign-born white persons

were more likely than U.S.-born white

persons to have completed a college

education. This finding may be related

to the fact that some immigrants come

to the United States to further their

education, although others are more

educated than U.S.-born persons when

they arrive in the United States (23,

40–41) or migrate based on particular

skills that are needed in various fields of

employment (38); therefore, it is not

surprising that many foreign-born

persons have a higher level of education

than their U.S-born counterparts.

Differences were also noted in the

health characteristics of the foreign- and

U.S.-born populations in this study.

Foreign-born non-Hispanic black

persons were more likely than their

U.S.-born counterparts to assess their

health as excellent or very good, less

likely to have an activity limitation, and

less likely to experience restricted

activity days. These findings are

consistent with previous research that

has shown that foreign-born black

persons report better health than their

U.S.-born counterparts (28–36).

Although foreign-born white persons

were equally likely to report their health

as excellent or very good as their

U.S.-born counterparts, they were also

less likely to have an activity limitation

and less likely to experience restricted

activity days. Selection bias in the

migration process may account for many

of these differences. Persons with health

problems are less likely to migrate,

resulting in immigrants being a

relatively healthy group, a phenomenon

often described as the ‘‘healthy

immigrant’’ effect (42).

There were large differences in

smoking status among the study groups,

especially by sex. Overall, immigrants

were less likely to be current smokers

than their U.S.-born counterparts.

Immigrants were also less likely to have

ever smoked than U.S.-born persons

among both the non-Hispanic black and

non-Hispanic white populations and

among both women and men. The one

exception to this was current smoking

status among men: although foreignborn black men were less likely to be

current smokers than their U.S.-born
Series 10, No. 226 [ Page 7

counterparts, there was no difference in

current smoking status for foreign-born

white men compared with U.S.-born

white men. Overall, these results were

consistent with other studies that

showed that the prevalence of smoking

is lower in the countries of origin of

immigrants represented in this report,

and that immigrants to the United States

tend to retain the lower smoking rates of

their origin countries (43–44).

Our findings also show that one

third of foreign-born non-Hispanic black

adults and one-fourth of foreign-born

non-Hispanic white adults had their

blood tested for the AIDS virus. The

substantial proportion of immigrants

who had been tested likely reflects the

U.S. Government’s requirement that all

applicants for immigration be tested for

HIV (18). This policy became effective

in 1990, and immigrants with positive

tests were prevented from entering the

United States unless the HIV-positive

immigrant had a close family

relationship with a U.S. citizen or legal

resident and applied for a waiver. Even

prior to the change in law, from

1987–90, new immigrants whom the

Government suspected might have the

disease were frequently required to be

tested.

An important strength of this study

is that we were able to use 4 years of

data from a national health survey to

obtain a sufficiently large sample size to

produce reliable estimates for relatively

small populations, such as non-Hispanic

black and non-Hispanic white

immigrants. Data were also examined on

a wide range of health measures, which

will add new information to the existing

body of literature on immigrant health.

However, there were some

limitations to this study. One limitation

was the inability of non-Englishspeaking respondents to complete the

interview. If NHIS interviewers

encountered situations where

respondents could not be interviewed in

English, they were instructed to conduct

the interview through a bilingual

interpreter, if one could be found. Even

with an interpreter, however,

misunderstandings about the survey

questions or respondent’s answers could

have occurred. Although this happened

infrequently, it may have been more of a

problem for the foreign-born nonHispanic white population than the

foreign-born non-Hispanic black

population because most non-Hispanic

white immigrants arrive from countries

in which English is not widely spoken

(17). The majority of black immigrants,

on the other hand, are natives of former

British colonies where English was the

primary language (20). However,

foreign-born black persons who

emigrated from French-speaking

colonies may also have experienced

language difficulty. Communication

problems could lead to the

misinterpretation of questions and

answers, which could, in turn, cause

biases in the data. Unfortunately, the

extent to which language problems

affected the data used in this study

could not be determined.

Another limitation of this study is

that it did not explore differences within

the foreign-born population by country

of birth. Information on the actual

country of birth was not collected in the

1992–95 NHIS; only information on

whether the respondent was U.S.-born

or foreign-born was collected. Because

the economic and social well-being of

foreign-born populations varies widely

depending on their nation of origin (17),

the impact of these factors on the health

status of foreign-born persons in the

United States could be significant.

Recommendations for

Future Research

While this study presents an

overview of patterns of health status and

sociodemographic characteristics of

non-Hispanic white and non-Hispanic

black persons who are foreign-born or

U.S.-born, this report does not control

for socioeconomic status (SES) in these

analyses. Significant differences in SES

between race or nativity groups were

observed in this study, and controlling

for SES might help to explain some of

these differences. Some research

examining the contribution of SES to

explaining differences between race or

nativity groups has suggested that social

factors contribute little in explaining or

determining the health of populations

(38), although other research has

suggested the opposite (39). Future

research should further explore what

role social inequality and other

dimensions of socioeconomic status

plays in race or nativity differences in

health, and to what degree this role is

altered by other factors such as selective

migration of people to the United States.

Studies have shown that acculturation

influences and plays a major role in

health for immigrants (13), and those

more recent immigrants are healthier

than immigrants who have lived in the

United States for 10 years or more (45).

Acculturation was not explored in this

study because the 1992–95 NHIS data

provided only a single measure of

acculturation: duration of residence in

the United States. Future studies should

use a variety of measures of

acculturation to investigate the health of

foreign-born populations as they

integrate into American society.

Another area that would benefit

from further research is the extent to

which sex differences play a role in

immigrant health. In this study, sex

differences were examined in smoking

status for the U.S.-born and foreign-born

black and white populations as one

example of these kinds of differences.

Studies have shown that race-nativity

patterns in demographic and health data

do vary considerably by sex (37–39).

Future analyses of NHIS data should

examine these differences in greater

detail and consider their role in

understanding variations in the health of

U.S.-born and foreign-born populations.

Conclusion

This analysis described differences

in various sociodemographic and health

characteristics for two little-studied

populations: foreign-born non-Hispanic

black and white persons. The results

show how immigrant populations differ

from their native counterparts and from

each other and illuminate variations that

are usually masked when nativity is not

considered when assessing differences in

social and health status by race. Our

findings also illustrate the usefulness of

looking at nativity status as possible

mechanism for understanding
Page 8 [ Series 10, No. 226

black-white differences in health status.

As non-Hispanic black and white

foreign-born populations in the United

States continue to grow, understanding

their health status and correlates of it

may assist in further explaining health

disparities among race groups in the

United States.

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Table 1. Number of persons and percent distribution of non-Hispanic U.S.- and foreign-born, by race: National Health Interview Survey,

average annual figures, 1992–95

Number in Percent

Nativity and race1 thousands distribution

Total non-Hispanic black...................................... 31,431 100.0

U.S.-born non-Hispanic black ................................. 29,892 4.9

Foreign-born non-Hispanic black ............................... 1,539 95.1

Total non-Hispanic white...................................... 185,781 100.0

U.S.-born non-Hispanic white ................................. 178,932 96.3

Foreign-born non-Hispanic white ............................... 6,849 3.7

Total population2 .......................................... 217,211 . . .

...Category not applicable.

1

Includes persons of all ages.

2

Includes all non-Hispanic black and white persons and all nativity groups.

NOTE: Figures may not add to 100% because of rounding.

SOURCE: National Health Interview Surveys, 1992–95.

Table 2. Percent distributions of selected demographic characteristics (with standard errors), by race and nativity: United States, average

annual figures, 1992–95

Selected demographic characteristics

Total

population1

U.S.-born nonHispanic blackForeign-born

non-Hispanic black

U.S.-born nonHispanic whiteForeign-born

non-Hispanic white

All persons................................ 217,211 29,892

Number in thousands

1,539 178,932 6,849

Age-adjusted percent distribution (standard error)

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

Sex

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

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

Mean age2................................

48.5 (0.08)

51.5 (0.08)

35.9 (0.09)

45.7 (0.23)

54.3 (0.23)

29.9 (0.17)

47.4 (1.16)

52.6 (1.16)

35.6 (0.38)

49.0 (0.08)

51.0 (0.08)

36.4 (0.10)

48.3 (0.62)

51.7 (0.62)

46.4 (0.31)

Age2

Under 5 years..............................

5–17 years................................

18–24 years ...............................

25–44 years ...............................

45–64 years ...............................

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

75 years and over ...........................

7.2 (0.06)

18.1 (0.10)

9.1 (0.13)

32.0 (0.11)

20.4 (0.11)

7.8 (0.08)

5.5 (0.07)

10.5 (0.18)

24.5 (0.27)

10.9 (0.20)

30.2 (0.25)

15.7 (0.23)

5.2 (0.13)

3.0 (0.10)

1.1 (0.26)

9.3 (0.70)

13.0 (0.83)

52.6 (1.20)

18.4 (0.89)

3.6 (0.38)

1.9 (0.26)

6.9 (0.06)

17.5 (0.11)

8.8 (0.14)

31.9 (0.12)

21.0 (0.12)

8.1 (0.09)

5.7 (0.08)

1.1 (0.12)

6.5 (0.33)

6.8 (0.30)

36.0 (0.55)

27.1 (0.50)

11.6 (0.36)

11.0 (0.37)

Education3

Less than high school graduate ...................

High school graduate .........................

Some college ..............................

College graduate or more ......................

33.8 (0.13)

30.7 (0.14)

17.5 (0.10)

17.9 (0.15)

43.6 (0.35)

30.1 (0.26)

15.5 (0.25)

10.8 (0.26)

39.1 (1.20)

27.9 (1.03)

15.7 (0.80)

17.3 (0.92)

32.5 (0.16)

31.0 (0.15)

17.8 (0.12)

18.7 (0.17)

34.0 (0.43)

24.6 (0.46)

17.3 (0.39)

24.1 (0.50)

Employment status4

Currently employed ..........................

Currently unemployed .........................

Not in labor force............................

64.9 (0.14)

3.1 (0.05)

32.1 (0.14)

57.1 (0.39)

4.6 (0.13)

38.3 (0.37)

64.5 (1.08)

3.8 (0.45)

31.7 (1.08)

66.3 (0.16)

2.8 (0.05)

30.9 (0.15)

61.2 (0.53)

3.1 (0.20)

35.7 (0.51)

Family income

Less than $20,000 ...........................

$20,000-$34,999 ............................

$35,000 and over ...........................

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

22.5 (0.25)

20.9 (0.17)

40.4 (0.29)

16.2 (0.32)

39.6 (0.77)

17.6 (0.37)

20.0 (0.49)

22.8 (0.86)

28.2 (1.85)

18.8 (1.55)

28.1 (1.81)

24.9 (1.86)

19.4 (0.26)

21.5 (0.19)

44.1 (0.33)

14.9 (0.30)

22.1 (0.86)

20.2 (0.76)

41.1 (0.98)

16.6 (0.70)

Poverty status5

At or above poverty ..........................

Below poverty..............................

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

81.4 (0.25)

10.3 (0.17)

8.3 (0.22)

59.1 (0.76)

24.9 (0.64)

16.0 (0.78)

70.9 (1.87)

15.1 (1.38)

14.0 (1.50)

85.3 (0.23)

7.7 (0.17)

7.0 (0.18)

82.1 (0.85)

9.9 (0.71)

8.0 (0.51)

See footnotes at end of table.
Series 10, No. 226 [ Page 11

Table 2. Percent distributions of selected demographic characteristics (with standard errors), by race and nativity: United States, average

annual figures, 1992–95—Con.

Total U.S.-born non- Foreign-born U.S.-born non- Foreign-born

Selected demographic characteristics population1 Hispanic black non-Hispanic black Hispanic white non-Hispanic white

Family size Age-adjusted percent distribution (standard error)

1–3 members .............................. 59.0 (0.19) 57.2 (0.46) 48.7 (1.69) 59.3 (0.20) 59.2 (0.81)

4–5 members .............................. 34.2 (0.17) 31.9 (0.41) 35.7 (1.71) 34.8 (0.18) 33.5 (0.88)

6 or more members .......................... 6.8 (0.12) 10.9 (0.34) 15.6 (1.59) 5.9 (0.12) 7.3 (0.80)

Geographic region

Northeast ................................ 20.2 (0.22) 14.7 (0.55) 52.5 (2.45) 20.3 (0.27) 31.2 (1.00)

Midwest ................................. 26.8 (0.23) 20.2 (0.78) 7.3 (1.04) 28.5 (0.30) 16.9 (0.78)

South ................................... 35.2 (0.28) 56.2 (1.05) 31.1 (2.44) 32.3 (0.37) 22.7 (0.95)

West ................................... 17.8 (0.20) 8.9 (0.42) 9.0 (1.25) 19.0 (0.25) 29.2 (1.12)

Place of residence6

MSA, central city ............................ 27.8 (0.43) 56.7 (1.29) 57.9 (2.72) 22.4 (0.43) 35.8 (1.16)

MSA, not central city ......................... 48.9 (0.50) 27.9 (1.02) 40.4 (2.71) 52.2 (0.55) 53.5 (1.21)

Non-MSA7 ................................ 23.4 (0.38) 15.4 (1.41) 1.7 (0.50) 25.4 (0.48) 10.7 (0.73)

Years in United States7

Less than 1 year ............................ 5.4 (0.39) . . . 4.1 (0.86) . . . 5.9 (0.57)

1 to less than 5 years ......................... 19.8 (0.56) . . . 19.2 (1.34) . . . 19.5 (0.79)

5 to less than 10 years ........................ 16.2 (0.44) . . . 20.3 (1.17) . . . 13.7 (0.61)

10 to less than 15 years ....................... 12.5 (0.40) . . . 18.7 (1.18) . . . 10.3 (0.52)

15 years or more ............................ 46.1 (0.46) . . . 37.6 (1.20) . . . 50.6 (0.61)

...Category not applicable.

1

Includes all non-Hispanic black and white persons and all nativity groups.

2

Age estimates are not standardized.

3

For persons 5 years of age and older.

4

For persons 18 years of age and older.

5

Poverty status is based on family size, number of children under 18 years old, and family income.

6

MSA is metropolitan statistical area.

7

Years of residencce in the United States is asked of all foreign-born persons.

NOTE: Figures may not add to 100% because of rounding.

SOURCE: National Health Interview Surveys, 1992–95.
Page 12 [ Series 10, No. 226

Table 3. Age-adjusted percent distributions of selected health characteristics (with standard errors), by race and nativity: United States,

average annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonSelected health characteristics Population1 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

All persons................................ 217,211 29,892 1,539 178,932 6,849

Age-adjusted percent distribution (standard error)

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

Respondent-assessed health status2

Excellent ................................. 38.3 (0.19) 27.5 (0.36) 37.8 (1.59) 40.0 (0.22) 39.6 (0.86)

Very good ................................ 28.9 (0.14) 24.9 (0.34) 29.6 (1.91) 29.4 (0.15) 29.3 (0.71)

Good ................................... 22.6 (0.12) 29.1 (0.31) 22.7 (1.30) 21.3 (0.14) 22.0 (0.59)

Fair to poor ............................... 10.3 (0.09) 18.6 (0.33) 9.9 (0.70) 9.2 (0.10) 9.1 (0.34)

Activity limitation status2

Not limited or unknown ........................ 84.1 (0.11) 80.0 (0.28) 88.6 (0.71) 84.5 (0.12) 86.4 (0.39)

Limited .................................. 15.9 (0.11) 20.0 (0.28) 11.4 (0.71) 15.5 (0.12) 13.6 (0.34)

Unable to perform major activity .................. 4.7 (0.06) 8.3 (0.17) 3.9 (0.47) 4.3 (0.06) 4.0 (0.21)

Limited in kind/amount of major activity .............. 6.1 (0.06) 7.0 (0.16) 4.4 (0.53) 6.1 (0.07) 5.1 (0.23)

Limited in other activity ........................ 5.1 (0.05) 4.7 (0.12) 3.1 (0.41) 5.2 (0.06) 4.5 (0.22)

Interval since last physician contact

Less than 1 year ............................ 79.7 (0.11) 79.1 (0.26) 79.4 (1.15) 80.0 (0.12) 78.4 (0.59)

1 to less than 2 years ......................... 9.5 (0.07) 10.5 (0.18) 10.3 (0.86) 9.3 (0.08) 9.4 (0.41)

2 to less than 5 years ......................... 7.7 (0.06) 7.4 (0.16) 7.1 (0.53) 7.7 (0.07) 8.7 (0.39)

5 years or more ............................ 3.1 (0.04) 3.1 (0.10) 3.2 (0.53) 3.0 (0.04) 3.6 (0.22)

1

Includes all non-Hispanic black and white persons and all nativity groups.

2

Includes persons of all ages.

NOTES: Figures may not add to 100% because of rounding. See ‘‘Appendix I, table II’’ for the unadjusted percent distirbutions for this table.

SOURCE: National Health Interview Surveys, 1992–95.

Table 4. Age-adjusted mean number of physician contacts and restricted activity days per year (with standard errors), by race and nativity:

United States, average annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonSelected health indicator population1 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

All persons ............................. 217,211 29,892 1,539 178,932 6,849

Age-adjusted mean number (standard error)

Physician contacts2 ........................ 6.3 (0.04) 6.2 (0.11) 5.0 (0.46) 6.4 (0.05) 5.6 (0.25)

Restricted activity days2 ..................... 16.7 (0.18) 22.4 (0.49) 11.7 (1.29) 16.2 (0.19) 14.6 (0.68)

Bed disability days2 ...................... 6.4 (0.08) 9.9 (0.26) 6.3 (0.86) 6.0 (0.09) 5.7 (0.35)

Work-loss days3 ........................ 3.8 (0.06) 4.8 (0.19) 3.3 (0.59) 3.7 (0.06) 3.0 (0.27)

School-loss days4 ....................... 4.8 (0.10) 4.8 (0.26) *1.2 (0.47) 4.8 (0.11) 5.7 (1.08)

Other restricted activity2.................... 8.4 (0.12) 10.1 (0.33) 4.2 (0.71) 8.3 (0.13) 7.3 (0.49)

* Figure does not meet standard of reliability and precision.

1

Includes all non-Hispanic black and white persons and all nativity groups.

2

Includes persons of all ages.

3

For persons 18 years of age and over.

4

For persons 5–17 years of age.

NOTES: Figures may not add to 100% because of rounding. See ‘‘Appendix I, table III’’ for the unadjusted estimates for this table.

SOURCE: National Health Interview Surveys, 1992–95.
Series 10, No. 226 [ Page 13

Table 5. Number of persons, hospital stays, and days of hospitalization and age-adjusted percent distribution of number of hospital

stays (with standard errors), by race and nativity: United States, average annual figures, 1992–95

Total U.S.-born non- Foreign-bornnon- U.S.-born non- Foreign-born nonHospital stay1 population2 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

Number of persons3 ....................... 217,211 29,892 1,539 178,932 6,849

Number of hospital stay3..................... 19,689 2,769 79 16,163 677

Number of days of hospitalization3

............... 119,238 18,992 526 94,967 4,753

Age-adjusted percent distribution (standard error)

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

No hospital stays ......................... 93.3 (0.05) 92.2 (0.15) 94.7 (0.58) 93.4 (0.05) 94.4 (0.23)

1 or more hospital stays ..................... 6.7 (0.05) 7.8 (0.15) 5.3 (0.58) 6.6 (0.05) 5.6 (0.23)

1

Hospital stay is any continuous period of stay of one night or more in a hospital as an inpatient, except the period of stay of a well newborn infant.

2

Includes all non-Hisapanic black and white persons and all nativity groups.

3

Rounded to the nearest integer.

NOTES: Figures may not add to 100% because of rounding.

See ‘‘Appendix I, table IV’’ for the unadjusted estimates for this table.

SOURCE: National Health Interview Surveys, 1992–95.

Table 6. Age-adjusted percent distributions of smoking status (with standard errors), by sex, race and nativity: United States, average

annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonSmoking status1 population2 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

All persons................................ 166,980 19,275 1,407 137,972 8,325

Age-adjusted percent distribution (standard error)

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

Current .................................. 26.0 (0.24) 27.9 (0.63) 11.1 (1.68) 26.3 (0.27) 22.5 (0.88)

Former .................................. 25.2 (0.20) 17.1 (0.49) 12.1 (2.03) 26.5 (0.22) 22.9 (0.84)

Never smoked ............................. 48.8 (0.25) 55.0 (0.70) 76.7 (2.56) 47.2 (0.28) 54.5 (1.03)

Age-adjusted percent distribution (standard error) by sex

Men

Current .................................. 27.6 (0.33) 32.9 (1.12) 17.7 (3.23) 27.3 (0.36) 25.9 (1.34)

Former .................................. 30.9 (0.30) 21.1 (0.82) 23.2 (4.09) 32.2 (0.33) 29.9 (1.34)

Never smoked ............................. 41.5 (0.35) 45.9 (1.15) 59.1 (4.59) 40.4 (0.39) 44.3 (1.51)

Women

Current .................................. 24.6 (0.30) 24.0 (0.70) 6.2 (1.59) 25.3 (0.35) 19.3 (1.13)

Former .................................. 20.4 (0.27) 14.1 (0.57) 4.8 (1.44) 21.7 (0.32) 17.5 (0.98)

Never smoked ............................. 55.0 (0.33) 61.9 (0.82) 89.0 (2.08) 53.0 (0.38) 63.3 (1.35)

1

Includes persons 18 years of age and over.

2

Includes all non-Hispanic black and white persons and all nativity groups.

NOTES: Figures may not add to 100% because of rounding. See ‘‘Appendix I, table V’’ for the unadjusted estimates for this table.

SOURCE: National Health Interview Surveys, 1992–95.
Page 14 [ Series 10, No. 226

Table 7. Age-adjusted percent distributions of AIDS knowledge, testing, and perceived risk (with standard errors), by race and nativity:

United States, average annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonAIDS knowledge, testing, and risk1,2 population3 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

All persons ............................. 168,081 19,429 1,429 138,996 8,226

Age-adjusted percent distribution (standard error)

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

Self-reported AIDS knowledge1

A lot ................................. 31.9 (0.24) 29.1 (0.59) 32.7 (2.34) 32.1 (0.27) 33.1 (0.99)

Some ................................ 45.1 (0.24) 36.0 (0.63) 37.0 (2.57) 46.8 (0.26) 37.5 (0.97)

A little ................................ 17.1 (0.19) 21.1 (0.53) 20.5 (2.37) 16.2 (0.21) 21.1 (0.83)

Nothing ............................... 6.0 (0.11) 13.8 (0.45) 9.8 (1.78) 4.9 (0.11) 8.2 (0.59)

Ever had blood tested for the AIDS virus

infection (excluding blood donations)1

Yes ................................. 22.7 (0.23) 33.4 (0.66) 32.7 (2.42) 20.8 (0.23) 27.0 (0.88)

No .................................. 77.3 (0.23) 66.6 (0.66) 67.3 (2.42) 79.2 (0.23) 73.0 (0.88)

Perceived risk of getting the AIDS virus1

High/medium ............................ 4.4 (0.09) 7.3 (0.34) 6.5 (1.33) 3.9 (0.10) 3.7 (0.40)

Low.................................. 32.8 (0.26) 29.9 (0.65) 30.8 (2.30) 33.4 (0.29) 28.4 (0.97)

None ................................. 62.9 (0.27) 62.7 (0.70) 62.7 (2.56) 62.6 (0.29) 67.9 (1.02)

1

AIDS is acquired immunodefiency syndrome.

2

Includes persons 18 years of age and older.

3

Includes all non-Hispanic black and white persons and all nativity groups.

NOTES: Figures may not add to 100 percent because of rounding. See ‘‘Appendix I, table VI’’ for the unadjusted estimates for this table.

SOURCE: National Health Interview Surveys, 1992–95.
Series 10, No. 226 [ Page 15

Appendix I

Technical Notes on

Methods

Sample Design

The National Health Interview

Survey (NHIS) is a cross-sectional

household interview survey of the

civilian noninstitutionalized population

of the United States. Data collection is

continuous throughout each year, and

the sampling plan follows a multistage

area probability design that permits the

representative sampling of households.

Sampling is done throughout the

continental United States, Alaska, and

Hawaii (the 50 States and the District of

Columbia); dependent areas of the

United States (Puerto Rico, Virgin

Islands, Guam, and others) are not

sampled in the NHIS.

Response Rate

The 1992–95 NHIS contained

completed interviews from a total of

187,029 households and 456,729

persons. The average annual household

response rate to the 1992–95 NHIS core

questionnaire was 94.6 percent. The

overall household response rate to NHIS

supplements is estimated as a product of

the core response rate and the

supplement response rate. From 1992

through 1995, 77,556 persons completed

the AIDS knowledge and attitudes

supplement. The average annual

supplement response rates and the

overall supplement response rates for

the AIDS knowledge and attitudes

supplement in 1992–95 were

84.4 percent and 79.8 percent,

respectively. The 1992–95 NHIS

supplements related to smoking habits

were completed by 70,088 persons. The

average annual supplement response

rates and overall supplement response

rates for the supplements containing the

smoking questions were 86.2 percent

and 81.5 percent, respectively. The

year-specific data on the number of

interviews, households, and the

household response rates can be found

in table I.

Precision of Estimates

All estimates (with the exception of

the variable age) are age-adjusted and

most are also presented as unadjusted

estimates. Considering the varying age

structures of the populations under

study, age adjustment is a necessary tool

to compare estimates in a more

meaningful manner. The direct method

of age adjustment was used, and the

projected 2000 U.S. population provided

by the Census Bureau was used as the

standard population (46). For variables

that covered all ages, the following age

groups were used for standardization:

under 5 years, 5–17 years, 18–24 years,

25–44 years, 45–64 years, 65–74 years,

and 75 years and over. For variables that

were restricted to persons of a particular

age (such as employment status of

persons 18 and over) only age groups

within the restricted range were used

(such as 18–24 years, 25–44 years,

45–64 years, and 65 years and over).

The relative standard error (RSE)

was used as a criterion of precision. The

RSE of an estimate is calculated by

dividing the standard error of the

estimate by the estimate itself and

expressing the ratio as a percent. In the

tables, estimates with a RSE of

30 percent or greater are shown with an

asterisk (*), indicating that those

estimates do not meet the conventional

NHIS standard for adequate precision

and stability. The statistical package

SUDAAN (25) was used to analyze

NHIS data.

Tests of Significance

Two-tailed t-tests of significance

were performed on all the comparisons

discussed in this report (no adjustments

were made for multiple comparisons).

The test statistic used to determine

statistical significance of the difference

between two percents was:

|Xa–Xb|

Z = √Sa

2 + Sb2

where Xa and Xb are the two percents

being compared, and Sa and Sb are the

SUDAAN-calculated standard errors of

those percents. The critical value used

for two-sided t-tests at the 0.05 level of

significance was 1.96.

Table I. Response rate, number of persons, and number of households interviewed for the core questionnaire and selected supplements:

National Health Interview Survey, 1992–95

Core questionnaire Smoking supplement1 AIDS knowledge and attitudes supplement2

Year

Response

rate

Number of

persons

interviewed

Total

number of

households

Response

rate

Overall

response

rate

Number of

persons

inteviewed

Response

rate

Overall

response

rate

Number of

persons

interviewed

1992 ..............

1993 ..............

1994 ..............

1995 ..............

95.7

94.7

94.1

93.8

128,412

109,671

116,179

102,467

51,642

44,978

48,584

41,824

90.0

85.7

84.5

86.2

86.1

81.2

79.5

80.9

12,005

21,028

19,738

17,317

86.9

84.5

81.9

83.8

83.2

80.0

77.1

78.6

20,974

20,607

19,127

16,848

1

Cigarette smoking questions were included in Cancer Epidemiology (1992) and Year 2000 Objectives (1993, 1994, 1995) supplements.

2

AIDS is acquired immunodeficiency syndrome.

NOTE: See ‘‘Technical Notes’’ for definitions of the terms ‘‘response rate’’ and ‘‘overall response rate.’’

SOURCE: National Health Interview Surveys, 1992–95.
Page 16 [ Series 10, No. 226

Appendix II

Definition of Terms

Below are the definitions for the

variables examined in this report, listed

alphabetically. The definitions do not

necessarily represent how the variables

were defined in the NHIS, but describe

how they were defined in the report.

Activity limitation status—This

refers to a long-term reduction in a

person’s capacity to perform the average

kind or amount of major activity usually

associated with his or her age group.

Major activity—The major activities

for the age groups were: (a)

ordinary play for children under 5

years of age; (b) attending regular

school for those 5–17 years of age;

(c) working or keeping house for

persons 18–69 years of age; and (d)

living independently (e.g., the

ability to bathe, shop, dress, and eat

without needing the help of another

person) for those 70 years of age

and over.

Age—Age was recorded for each

person as the age at last birthday.

AIDS variables—The knowledge

question asked, ‘‘How much would you

say you know about AIDS—a lot, some,

a little, or nothing?’’ This was the

respondent’s perception of his or her

own AIDS knowledge, a subjective

measure.

Risk—‘‘What are your chances of

getting the AIDS virus; would you

say high, medium, low, or none?’’

The high and medium categories

were combined.

Testing—The testing question

excluded blood donations since

1985. It asked ‘‘(Except for tests

you may have had as part of blood

donations,) have you ever had your

blood tested for the AIDS virus

infection?’’

Day of hospitalization—A day of

hospitalization was a day in which a

person was confined to a hospital. It

was counted as a hospital day only if

the patient stayed overnight.

Education—Persons 5 years of age

and over were classified as less than a

high school graduate, a high school

graduate, completed some college, or

college graduate or more.

Employment status—Employment

status included persons 18 years of age

and over.

Currently employed—This category

included anyone who reported that

at any time during the 2-week

period covered by the interview

they either worked at or had a job

or business; persons with part-time

employment were included in this

category.

Currently unemployed—This

category included those who had

been laid off or were looking for

work.

Not in labor force—This category

included retirees, students,

homemakers, and others who were

not seeking employment.

Family income—Each family

member was classified according to the

same total family income. The income

was the sum of all income received by

household members related to each

other by blood, adoption, or marriage in

the 12-month period preceding the week

of the interview. The income recorded

was the total income received by all

family members in the previous calendar

year. Income from all sources including,

wages, salaries, pensions, government

payments, child support or alimony,

dividends, help from relatives, etc., was

included. This variable was categorized

as less than $20,000, $20,000–$34,999,

$35,000 or more, and unknown. The

‘‘unknown’’ category included

nonresponses. A substantial proportion

of data is missing for this variable due

to the hesitancy of some survey

participants to disclose information

about their annual income.

Family size—Family size was

defined as the number of kinfolk

residing in the sample household and

categorized as 1–3 members, 4–5

members, or 6 or more members.

Geographic region of residence—

The States were grouped into four

regions corresponding to those used by

the U.S. Census Bureau. The regions

included the following States:

Region States included

Northeast Maine, Vermont, New

Hampshire, Massachusetts,

Connecticut, Rhode Island,

New York, New Jersey,

and Pennsylvania

Midwest Ohio, Illinois, Indiana,

Michigan, Wisconsin,

Minnesota, Iowa, Missouri,

North Dakota, South Dakota,

Kansas, and Nebraska

South Delaware, Maryland, District

of Columbia, West Virginia,

Virginia, Kentucky,

Tennessee, North Carolina,

South Carolina, Georgia,

Florida, Mississippi,

Alabama, Louisiana,

Oklahoma, Arkansas, and

Texas

West Washington, Oregon,

California, Nevada, New

Mexico, Arizona, Idaho,

Utah, Colorado, Montana,

Wyoming, Alaska, and

Hawaii

Health status—The categories

related to this concept result from

asking the respondent, ‘‘Would you say

________’s health is excellent, very

good, good, fair, or poor?’’ It was based

on a family respondent’s opinion and

not directly on any clinical evidence.

Hospital stay—A hospital stay was

any continuous period of stay of one

night or more in a hospital as an

inpatient, except the period of stay of a

well newborn infant.

Interval since last physician

contact—The interval since last

physician contact was ascertained by

asking persons interviewed about how

long it had been since they last saw or

talked to a medical doctor or doctor’s

assistant.

Nativity—Nativity was defined as

having been born in the United States or

abroad.

U.S.-born—This category included

those individuals born in 1 of the

50 United States or the District of

Columbia. Individuals born in U.S.
Series 10, No. 226 [ Page 17

dependencies are included in this

category.

Foreign-born—This category

included those individuals born

outside of the 50 United States, the

District of Columbia, and any of the

U.S. dependencies.

Physician contact—A physician

contact was a consultation with a

physician, nurse, or other person acting

under a physician’s supervision. The

consultation could have been in person

or by telephone and for the purpose of

an examination, diagnosis, treatment, or

advice.

Place of residence—The place of

residence of an individual was classified

as inside a metropolitan statistical area

(MSA) or outside an MSA. It was

further classified as either central city or

not central city.

Metropolitan statistical area—The

definition and titles of MSAs were

established by the U.S. Office of

Management and Budget with the

advice of the Federal Committee on

Metropolitan Statistical Areas. A

MSA consists of a county or group

of counties containing at least one

city that had a population of 50,000

or more, plus adjacent counties that

were metropolitan in character and

were economically and socially

integrated with the central city.

Central city—The largest city in a

MSA is always a central city.

Not central city—This includes all

of the MSA that is not part of the

central city itself.

Not in MSA—This includes all other

places in the county other than

MSAs.

Poverty status—Poverty status was

based on family size, number of

children under 18 years of age, and

family income, using thresholds set by

the Census Bureau.

Restricted activity day—A restricted

activity day was a general term

encompassing the following four

measures: bed disability days, work-loss

days (for currently employed persons 18

years of age and over), and school-loss

days (for children 5–17 years of age).

The number of restricted activity days

was the number of days on which a

person experienced at least one of the

four types of activity restriction.

Bed disability day—A day during

which a person stayed in bed more

than one-half day because of illness

or injury.

Work-loss day—A day in which an

employed person 18 years of age or

over missed more than one-half day

of work due to illness.

School-loss day—A day in which a

child 5–17 years old missed more

than one-half day of school due to

illness or injury.

Current smoker—Current smokers

included anyone who had smoked at

least 100 cigarettes in his/her lifetime

and who currently smoke every day or

some days.

Former smoker—Former smokers

included those who had smoked at least

100 cigarettes in their life, but did not

currently smoke every day or some

days.

Never smoked—Persons who never

smoked included those who never

smoked a cigarette during their lifetime.
Page 18 [ Series 10, No. 226

Appendix III

Tables of Unadjusted

Estimates for Selected

Tables and Health

Outcomes

Unadjusted estimates for tables 3–7

are provided in this appendix for

comparison with the adjusted estimates

presented in the report. Table II provides

the unadjusted estimates for the health

outcomes in table 3; table III provides

the unadjusted estimates for the health

outcomes in table 4; and so on. Note

that in table V, unadjusted estimates are

provided only for overall smoking status

and not for smoking status by sex.

Table II. Unadjusted percent distributions of selected health characteristics (with standard errors), by race and nativity: United States,

average annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonSelected health characteristics population1 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

All persons ........................... 217,211 29,892 1,539 178,932 6,849

Unadjusted percent distribution (standard error)

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

Respondent-assessed health status2

Excellent ............................ 38.2 (0.18) 30.5 (0.40) 38.5 (1.47) 39.6 (0.21) 34.2 (0.62)

Very good ........................... 28.9 (0.14) 25.8 (0.36) 32.2 (1.80) 29.4 (0.15) 28.5 (0.54)

Good .............................. 22.6 (0.12) 28.6 (0.33) 21.5 (1.08) 21.5 (0.13) 24.8 (0.49)

Fair to poor .......................... 10.3 (0.09) 15.1 (0.29) 7.7 (0.56) 9.4 (0.10) 12.6 (0.44)

Activity limitation status2

Not limited or unknown ................... 84.1 (0.11) 83.4 (0.26) 91.6 (0.61) 84.3 (0.12) 82.3 (0.47)

Limited ............................. 15.9 (0.11) 16.6 (0.26) 8.4 (0.61) 15.7 (0.12) 17.7 (0.47)

Unable to perform major activity.............. 4.7 (0.06) 6.6 (0.15) 3.1 (0.38) 4.4 (0.06) 5.4 (0.27)

Limited in kind/amount of major activity ......... 6.1 (0.06) 6.1 (0.15) 2.9 (0.37) 6.1 (0.07) 6.5 (0.27)

Limited in other activity ................... 5.1 (0.05) 3.8 (0.11) 2.4 (0.30) 5.3 (0.06) 5.8 (0.24)

Interval since last physician contact

Less than 1 year ....................... 79.7 (0.11) 78.7 (0.27) 76.0 (1.18) 80.0 (0.12) 78.1 (0.48)

1 to less than 2 years .................... 9.4 (0.07) 11.0 (0.19) 10.9 (0.77) 9.2 (0.08) 9.0 (0.31)

2 to less than 5 years .................... 7.8 (0.07) 7.4 (0.17) 9.2 (0.62) 7.8 (0.07) 9.0 (0.32)

5 years or more........................ 3.1 (0.04) 2.9 (0.10) 3.9 (0.57) 3.1 (0.04) 4.0 (0.21)

1

Includes all non-Hispanic black and white persons and all nativity groups.

2

Includes persons of all ages.

NOTES: Figures may not add to 100% because of rounding. See table 3 for the adjusted estimates for this table. SOURCE: National Health Interview Surveys, 1992–95.
Series 10, No. 226 [ Page 19

Table III. Unadjusted mean number of physician contacts and restricted activity days per year (with standard errors), by race and nativity:

United States, average annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonSelected health indicator population1 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

All persons ............................. 217,211 29,892 1,539 178,932 6,849

Unadjusted mean number of physician contacts (standard error)

Physician contacts2 ........................ 6.3 (0.04) 5.6 (0.10) 4.2 (0.33) 6.4 (0.05) 6.2 (0.20)

Restricted activity day2 ...................... 16.7 (0.17) 18.8 (0.40) 10.2 (1.01) 16.4 (0.19) 18.0 (0.87)

Bed disability days2 ...................... 6.4 (0.08) 8.3 (0.21) 4.9 (0.57) 6.0 (0.09) 7.1 (0.46)

Work-loss days3 ........................ 2.6 (0.04) 2.9 (0.11) 2.8 (0.47) 2.5 (0.04) 2.4 (0.21)

School-loss days4 ....................... 0.9 (0.02) 1.2 (0.07) 0.1 (0.04) 0.8 (0.02) 0.4 (0.07)

Other restricted activity2.................... 8.4 (0.12) 8.2 (0.26) 3.7 (0.53) 8.4 (0.13) 9.4 (0.64)

1

Includes all non-Hispanic black and white persons and all nativity groups.

2

Includes persons of all ages.

3

For persons 18 years of age and over.

4

For persons 5–17 years of age.

NOTES: Figures may not add to 100% because of rounding. See table 4 for the adjusted estimates for this table. SOURCE: National Health Interview Surveys, 1992–95.

Table IV. Number of persons, hospital stays, and days of hospitalization, and unadjusted percent distribution of number of hospital

stays (with standard errors), by race and nativity: United States, average annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonHospital stay1 population2 Hispanic black Hispanic black Hispanic white Hispanic white

Number in thousands

Number of persons3 ....................... 217,211 29,892 1,539 178,932 6,849

Number of hospital stays3 .................... 19,689 2,769 79 16,163 677

Number of days of hospitalization3

............... 119,238 18,992 526 94,967 4,753

Unadjusted percent distribution (standard error)

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

No hospital stays ......................... 93.3 (0.05) 93.3 (0.13) 95.8 (0.37) 93.3 (0.06) 92.7 (0.27)

1 or more hospital stays ..................... 6.7 (0.05) 6.7 (0.13) 4.2 (0.37) 6.7 (0.06) 7.3 (0.27)

1

Hospital stay is any continuous period of stay of one night or more in a hospital as an inpatient, except the period of stay of a well newborn infant.

2

Includes all non-Hisapanic black and white persons and all nativity groups.

3

Rounded to the nearest whole number.

NOTES: Figures may not add to 100% because of rounding. See table 5 for the adjusted estimates for this table.

SOURCE: National Health Interview Surveys, 1992–95.

Table V. Unadjusted percent distribution of smoking status (with standard errors), by race and nativity: United States, average annual

figures, 1992–95

Smoking status1

Total

population2

U.S.-born nonHispanic blackForeign-born nonHispanic blackU.S.-born nonHispanic whiteForeign-born nonHispanic white

Number in thousands

All persons ............................. 166,980 19,275 1,407 137,972 8,325

Unadjusted percent distribution (standard error)

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

Current ...............................

Former................................

Never smoked ...........................

100.0

26.1 (0.24)

24.9 (0.21)

49.0 (0.26)

100.0

27.8 (0.63)

15.2 (0.47)

57.0 (0.70)

100.0

11.4 (1.72)

10.7 (1.94)

77.9 (2.49)

100.0

26.2 (0.27)

26.5 (0.24)

47.3 (0.29)

100.0

22.6 (0.87)

23.0 (0.85)

54.4 (1.03)

1

Includes persons 18 years of age and over.

2

Includes all non-Hispanic black and white persons and all nativity groups.

NOTES: Figures may not add to 100% because of rounding. See table 6 for the adjusted estimates for this table.

SOURCE: National Health Interview Surveys, 1992–95.
Page 20 [ Series 10, No. 226

Table VI. Unadjusted percent distributions of AIDS knowledge, testing, and perceived risk (with standard errors), by race and nativity:

United States, average annual figures, 1992–95

Total U.S.-born non- Foreign-born non- U.S.-born non- Foreign-born nonAIDS knowledge, testing, and risk1,2 population3 Hispanic black Hispanic black Hispanic white Hispanic black

Number in thousands

All persons................................ 168,081 19,429 1,429 138,996 8,226

Unadjusted percent distribution (standard error)

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

Self-reported AIDS knowledge1

A lot .................................... 32.0 (0.25) 31.3 (0.63) 37.8 (2.42) 32.0 (0.28) 33.0 (0.97)

Some ................................... 45.0 (0.24) 37.4 (0.64) 38.2 (2.50) 46.6 (0.26) 37.6 (0.95)

A little ................................... 17.0 (0.20) 20.2 (0.51) 16.9 (1.97) 16.3 (0.22) 21.2 (0.83)

Nothing.................................. 6.0 (0.11) 11.2 (0.43) 7.1 (1.23) 5.1 (0.12) 8.2 (0.57)

Ever had blood tested for the AIDS

virus infection (excluding blood donations)1

Yes .................................... 23.3 (0.24) 36.4 (0.73) 39.3 (2.55) 21.0 (0.25) 27.8 (0.92)

No .................................... 76.7 (0.24) 63.6 (0.73) 60.8 (2.55) 79.0 (0.25) 72.2 (0.92)

Perceived risk of getting the AIDS virus1

High/medium .............................. 4.4 (0.10) 8.2 (0.39) 7.2 (1.41) 3.9 (0.10) 3.6 (0.38)

Low .................................... 33.0 (0.28) 31.9 (0.68) 34.5 (2.27) 33.4 (0.31) 28.4 (0.98)

None ................................... 62.6 (0.30) 59.9 (0.76) 58.4 (2.60) 62.7 (0.32) 68.0 (1.03)

1

AIDS is acquired immunodefiency syndrome.

2

Includes persons 18 years of age and older.

3

Includes all non-Hispanic black and white persons and all nativity groups.

NOTES: Figures may not add to 100 percent because of rounding. See table 7 for the adjusted estimates for this table.

SOURCE: National Health Interview Surveys, 1992–95.
Vital and Health Statistics

series descriptions

SERIES 1. Programs and Collection Procedures—These reports

describe the data collection programs of the National Center

for Health Statistics. They include descriptions of the methods

used to collect and process the data, definitions, and other

material necessary for understanding the data.

SERIES 2. Data Evaluation and Methods Research—These reports

are studies of new statistical methods and include analytical

techniques, objective evaluations of reliability of collected

data, and contributions to statistical theory. These studies

also include experimental tests of new survey methods and

comparisons of U.S. methodology with those of other

countries.

SERIES 3. Analytical and Epidemiological Studies—These reports

present analytical or interpretive studies based on vital and

health statistics. These reports carry the analyses further than

the expository types of reports in the other series.

SERIES 4. Documents and Committee Reports—These are 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 5. International Vital and Health Statistics Reports—These

reports are analytical or descriptive reports that compare U.S.

vital and health statistics with those of other countries or

present other international data of relevance to the health

statistics system of the United States.

SERIES 6. Cognition and Survey Measurement—These reports are

from the National Laboratory for Collaborative Research in

Cognition and Survey Measurement. They use methods of

cognitive science to design, evaluate, and test survey

instruments.

SERIES 10. Data From the National Health Interview Survey—These

reports contain statistics on illness; unintentional injuries;

disability; use of hospital, medical, and other health services;

and a wide range of special current health topics covering

many aspects of health behaviors, health status, and health

care utilization. They are based on data collected in a

continuing national household interview survey.

SERIES 11. Data From the National Health Examination Survey, the

National Health and Nutrition Examination Surveys, and

the Hispanic Health and Nutrition Examination Survey—

Data from direct examination, testing, and measurement on

representative samples of the civilian noninstitutionalized

population provide the basis for (1) medically defined total

prevalence of specific diseases or conditions in the United

States and the distributions of the population with respect to

physical, physiological, and psychological characteristics, and

(2) analyses of trends and relationships among various

measurements and between survey periods.

SERIES 12. Data From the Institutionalized Population Surveys—

Discontinued in 1975. Reports from these surveys are

included in Series 13.

SERIES 13. Data From the National Health Care Survey—These

reports contain statistics on health resources and the public’s

use of health care resources including ambulatory, hospital,

and long-term care services based on data collected directly

from health care providers and provider records.

SERIES 14. Data on Health Resources: Manpower and Facilities—

Discontinued in 1990. Reports on the numbers, geographic

distribution, and characteristics of health resources are now

included in Series 13.

SERIES 15. Data From Special Surveys—These reports contain

statistics on health and health-related topics collected in

special surveys that are not part of the continuing data

systems of the National Center for Health Statistics.

SERIES 16. Compilations of Advance Data From Vital and Health

Statistics—Advance Data Reports provide early release of

information from the National Center for Health Statistics’

health and demographic surveys. They are compiled in the

order in which they are published. Some of these releases

may be followed by detailed reports in Series 10–13.

SERIES 20. Data on Mortality—These reports contain statistics on

mortality that are not included in regular, annual, or monthly

reports. Special analyses by cause of death, age, other

demographic variables, and geographic and trend analyses

are included.

SERIES 21. Data on Natality, Marriage, and Divorce—These reports

contain statistics on natality, marriage, and divorce that are

not included in regular, annual, or monthly reports. Special

analyses by health and demographic variables and

geographic and trend analyses are included.

SERIES 22. Data From the National Mortality and Natality Surveys—

Discontinued in 1975. Reports from these sample surveys,

based on vital records, are now published in Series 20 or 21.

SERIES 23. Data From the National Survey of Family Growth—These

reports contain statistics on factors that affect birth rates,

including contraception, infertility, cohabitation, marriage,

divorce, and remarriage; adoption; use of medical care for

family planning and infertility; and related maternal and infant

health topics. These statistics are based on national surveys

of women of childbearing age.

SERIES 24. Compilations of Data on Natality, Mortality, Marriage, and

Divorce—These include advance reports of births, deaths,

marriages, and divorces based on final data from the National

Vital Statistics System that were published as National Vital

Statistics Reports (NVSR), formerly Monthly Vital Statistics

Report. These reports provide highlights and summaries of

detailed data subsequently published in Vital Statistics of the

United States. Other special reports published here provide

selected findings based on final data from the National Vital

Statistics System and may be followed by detailed reports in

Series 20 or 21.

For answers to questions about this report or for a list of reports published

in these series, contact:

Information Dissemination Staff

National Center for Health Statistics

Centers for Disease Control and Prevention

3311 Toledo Road, Room 5412

Hyattsville, MD 20782

1-866-441-NCHS (6247)

E-mail: nchsquery@cdc.gov

Internet: www.cdc.gov/nchs
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