Hispanic Health and Nutrition Examination Survey: methodological considerations.

Abstract

The Hispanic Health and Nutrition Examination Survey (HHANES) was the first special population survey undertaken by the National Center for Health Statistics. The HHANES was designed to assess the health and nutritional status and needs of Mexican Americans, mainland Puerto Ricans and Cuban Americans. Data were collected using five data collection techniques: direct physical examinations, diagnostic testing, anthropometry, laboratory analyses, and interviews. Unlike other surveys conducted by the National Center for Health Statistics, the HHANES was not designed as a national survey. The HHANES was a survey of three Hispanic subgroups of the population in selected areas of the United States with a survey universe that included approximately 76 percent of the 1980 Hispanic-origin population in the United States. This article discusses statistical issues that should be addressed by researchers when analyzing HHANES data. Specifically, analysts need to account for the complex sample design, nonresponse bias, potential non-coverage bias, and the regional nature of the HHANES sample.

Tuberculosis and Diabetes in Southern Mexico

“…The SE estimated obtained from weighted analysis in the Statistical Analysis System was adjusted by the average design effects (a ratio of the variance from a cluster sample to that from a simple random sample of the same size) for prevalence generated from SUDAAN 7.5.6 Software for Survey Data Analysis (Research Triangle Institute, Research Triangle Park, NC) and averaged across sex and 5-year age categories (16).…”

Health behaviors, risk factors, and health indicators associated with cigarette use in Mexican Americans: results from the Hispanic HANES.

“…Eighty-seven percent of Mexican Americans approached to participate in the HHANES completed the household interview while 76 percent completed the physician's examination. 36 It should be noted, however, that the weighting procedure incorporated in the present analysis includes adjustment for nonresponse. 36 Although national estimates of selfreported cigarette consumption are correlated with cigarette sales in the United States (average r = .72),37 specific analysis of self-report data from the HHANES suggest that underreporting of consumption may have occurred.…”

“…36 It should be noted, however, that the weighting procedure incorporated in the present analysis includes adjustment for nonresponse. 36 Although national estimates of selfreported cigarette consumption are correlated with cigarette sales in the United States (average r = .72),37 specific analysis of self-report data from the HHANES suggest that underreporting of consumption may have occurred. Based on serum levels ofcotinine, a principle metabolite of nicotine, Perez-Stable, et al,38 estimated that 20-25 percent of those reporting 1-9 cigarettes used per day were actually underreporting cigarette consumption, while underreporting estimates for those reporting greater than 10 cigarettes per day ranged from 2-11 percent.…”

Health care utilization barriers among Mexican Americans: evidence from HHANES 1982-84.

“…21 The current analyses focus on 3,935 Mexican Americans ages 20-74 years who were eligible for inclusion based on their having self-identified themselves as either Mexican, Mexican American, or Chicano.…”