The National Health Interview Survey (NHIS) provides a rich source of data for studying relationships between income and health and for monitoring health and health care for persons at different income levels. However, the nonresponse rates are high for two key items, total family income in the previous calendar year and personal earnings from employment in the previous calendar year. To handle the missing data on family income and personal earnings in the NHIS, multiple imputation of these items, along with employment status and ratio of family income to the federal poverty threshold (derived from the imputed values of family income), has been performed for the survey years 1997-2004. (There are plans to continue this work for years beyond 2004 as well.) Files of the imputed values, as well as documentation, are available at the NHIS website (http://www.cdc.gov/nchs/nhis.htm). This article describes the approach used in the multiple-imputation project and evaluates the methods through analyses of the multiply imputed data. The analyses suggest that imputation corrects for biases that occur in estimates based on the data without imputation, and that multiple imputation results in gains in efficiency as well.
Objective-This report estimates the prevalence of serious psychological distress (SPD) in the noninstitutionalized adult population of the United States, as measured by the K6 scale of nonspecific psychological distress, and describes the characteristics of adults with and without SPD. These findings are compared with results from previous studies of the characteristics of adults with serious mental illnesses that cause significant disability, such as severe major depression, bipolar disorder, and schizophrenia.Methods-The estimates in this report were derived from the Family Core and Sample Adult components of the 2001-04 National Health Interview Survey, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). Estimates were calculated using the SUDAAN statistical package to account for the complex survey design.Results-The prevalence of SPD was higher among adults 45-64 years old than younger adults 18-44 years or older adults 65 years and over. Adults with SPD were more likely to be female, have less than a high school diploma, and live in poverty, and less likely to be married than adults without SPD. Moreover, those with SPD were more likely to be obese and to be current smokers. They have a higher prevalence of ever being diagnosed with heart disease, diabetes, arthritis, and stroke than persons without SPD. Adults with SPD were more likely to report needing help with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). They also used more medical care services such as doctor visits and visits to mental health professionals than adults without SPD.Conclusions-The associations between SPD and sociodemographic characteristics, health status, and health care utilization are similar to the relationships found between serious mental illnesses (for example, major depression or schizophrenia) and these same variables. Persons with SPD demonstrate disadvantage in both socioeconomic status and health outcomes.
Kidney disease is an important complication of HIV, particularly in minority populations. We describe the burden of chronic kidney disease among 1239 adults followed at an urban AIDS center, with an estimated prevalence of 15.5% (n = 192). Independent predictors of kidney disease included older age, black race, hepatitis C virus exposure, and lower CD4 cell count. These data suggest that chronic kidney disease remains a common complication of HIV infection in the era of antiretroviral therapy.
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