Contributions of a local health examination survey to the surveillance of chronic and infectious diseases in New York City

Abstract

Objectives: We sought to evaluate the contribution of the New York City Health and Nutrition Examination Survey (NYC-HANES) to local public health surveillance.

Methods: Examination-diagnosed estimates of key health conditions from the 2004 NYC-HANES were compared with the National Health and Nutrition Examination Survey (NHANES) 2003-2004 national estimates. Findings were also compared with self-reported estimates from the Community Health Survey (CHS), an annually conducted local telephone survey.

Results: NYC-HANES estimated that among NYC adults, 25.6% had hypertension, 25.4% had hypercholesterolemia, 12.5% had diabetes, and 25.6% were obese. Compared with US adults, NYC residents had less hypertension and obesity but more herpes simplex 2 and environmental exposures (P<.05). Obesity was higher and hypertension was lower than CHS self-report estimates (P<.05). NYC-HANES and CHS self-reported diabetes estimates were similar (9.7% vs 8.7%).

Conclusions: NYC-HANES and national estimates differed for key chronic, infectious, and environmental indicators, suggesting the need for local data. Examination surveys may provide more accurate information for underreported conditions than local telephone surveys. Community-level health and nutrition examination surveys complement existing data, providing critical information for targeting local interventions.

FIGURE 1

Comparison of 2004 NYC-HANES self-reported and examination-based estimates to CHS self-reported 2002, 2004, and 2005 estimates for selected chronic conditions: 2004. Note. NYC-HANES = New York City Health and Nutrition Examination Survey; CHS = Community Health Survey. All estimates are age-adjusted to the 2000 US Standard population. ^aBased on the question, “Have you ever been told by a doctor or other health professional that you had hypertension, also called high blood pressure?” ^bBased on the question, “Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?” (CHS 2005). ^cEstimate was significantly different from NYC-HANES examination-based estimate (P < .05). ^dBased on the question, “Have you ever been told by a doctor or other health professional that your blood cholesterol level was high?” ^eBased on the question, “Have you ever been told by a doctor or health professional that your blood cholesterol is high?” (CHS 2002). ^fBased on the question, “[other than pregnancy], have you ever been told by a doctor or health professional that you have diabetes or sugar diabetes?” ^gBased on the question, “Have you ever been told by a doctor that you have diabetes?” A woman with a “yes” response was asked, “Was this only when you were pregnant?” ^hBased on the questions, “How tall are you without shoes?” and “How much do you weigh without clothes or shoes? [If you are currently pregnant, how much did you weigh before your pregnancy?]” ⁱBased on the questions, “About how tall are you without shoes?” and “About how much do you weigh without shoes?” If resondent was missing weight but not missing height, respondent was asked, “Do you weigh more than [critical weight for obese]?” and “Do you weigh less than [critical weight for overweight]?” If respondent was missing height but not missing weight, respondent was asked, “Is your height less than [critical height for obese]?” and “Is your height less than [critical height for overweight]?”