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Diabetes and OGTT Data, Ages 20 - 74 Years Tape Number 6506 Version 1, Hispanic Health and Nutrition Examination Survey, 1982-84

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service

Centers for Disease Control

Public UseData TapeDocumentationDiabetes and OGTT Data, Ages 20-74 YearsTape Number 6506Version 1, Hispanic Health and Nutrition Examination Survey, 1982-84

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPublic Health ServiceCenters for Disease ControlNational Center for Health Statistics

Hyattsville, MarylandReprinted May 1992

Hispanic Health and Nutrition Examination Survey

Mexican AmericansCuban Americans

Puerto Ricans

Tape Number 6506

DIABETES AND OGTT DATA

Ages 20 Years - 74 Years

Version 1

August 1988

The Hispanic Health and Nutrition Examination Survey (HHANES) was conductedfrom July 1982 through December 1984. The following information shows thetotal number of persons ages 6 months to 74 years sampled, interviewed andexamined in each of the three portions of the survey.

Mexican AmericansResiding in selected counties of Texas, Colorado, New Mexico,

Arizona, and CaliforniaSurveyed from July 1982 through November 19839,894 persons sampled; 8,554 interviewed; 7,462 examined

Cuban AmericansResiding in Dade County (Miami), FloridaSurveyed from January 1984 through April 19842,244 persons sampled; 1,766 interviewed; 1,357 examined

Puerto RicansResiding in the New York City area, including parts of New Jersey

and ConnecticutSurveyed from May 1984 through December 19843,786 persons sampled; 3,369 interviewed; 2,834 examined

The data on the tape documented here are for all examined persons ages 20 yearsto 74 years.

The following tape characteristics are those of the version of the tape kept atNCHS and of the tape transmitted to the National Technical Information Servicefor release to users:

Tape labels: IBM standardData set name: HHANES.DU650601Data set organization: Physical sequentialRecord format: Fixed blockRecord length: 600Block size: 24000Density: 6250 BP INumber of records: 5815Data code: EBCDIC

CAUTION

BEFORE USING THIS DATA TAPE,PLEASE READ THIS PAGE

o Read the accompanying description of the survey, “The Plan andOperation of the Hispanic Health and Nutrition Examination Survey”,DHHS Publication No. (PHS) 85-1321 before conducting analyses ofthe data on this tape.

o Two aspects of HHANES, especially, should be taken into accountwhen conducting any analyses: the sample weights and the complexsurvey design.

o Analyses should not be conducted on data combined from the threeportions of the survey (Mexican-American, Cuban-American, PuertoRican).

o HHANES is a survey of Hispanic households and some of the sample

persons included on this tape are not of Hispanic origin. A detaileddescription of the data codes dealing with national origin or ancestryappears in the NOTES section of this document.

o Examine the range and frequency of values of a variable beforeconducting an analysis of data. The range may include unusual orunexpected values. The frequency counts may be useful to determinewhich analyses may be worthwhile.

o Language of Interview, which may appear several places on this tape,can vary depending on the questionnaire (several used in the survey)and on whether the response was provided by the sample person or bya proxy.

o For some data items, reference is made to a note. The notes (in aseparate section of this document) may be very important in dataanalyses, Attention to them is strongly urged.

o For some data items, the number of sample persons with a positiveresponse is very small. In these instances, it may not be possible toproduce a reliable population estimate. Because the response ratesto the glucose tolerance component were under 50 percent, attentionto Section B regarding nonresponse bias is strongly urged.

This Public Use Data Tape has been edited very carefully. Numerous consistencyand other checks were also performed. Nevertheless, due especially to the largenumber of data items, some errors may have gone undetected.

Please bring to the attention of NCHS any errors in the data tape or thedocumentation. Errata sheets will be sent to people who have purchased thedata tapes and corrections will be made to subsequently released data tapes,

In publications, please acknowledge NCHS as the original data source. Theacknowledgment should include a disclaimer crediting the authors for analyses-,interpretations, and conclusions; NCHS should be cited as being responsible foronly the collection and processing of the data. In addition, NCHS requests thatthe acronym HHANES be placed in the abstracts of journal articles and otherpublications based on data from this survey in order to facilitate the retrieval ofsuch materials through automated bibliographic searches. Please send reprintsof journal articles and other publications that include data from this tape toNCHS. ‘

Division of Health Examination StatisticsNational Center for Health StatisticsCenter Building, Room 2-583700 East-West HighwayHyattsville, MD 20782

Public Use Data Tapes for the Hispanic Health and Nutrition Examination Surveywill be released through the National Technical Information Service (NTIS) assoon as the data have been edited, validated, and documented. A list of NCHSPublic Use Data Tapes that can be purchased from NTIS may be obtained bywriting the Scientific and Technical Information Branch, NCHS.

Scientific and Technical Information BranchNational Center for Health StatisticsCenter Building, Room 1-573700 East-West HighwayHyattsville, MD 20782301-436-8500

CONTENTS

Section

Section

Section

Section

Section

Section

Section

Section

Section

Section

Section

Section

Section

Section

A.

B.

c.

D.

E.

F.

G.

H.

1.

J.

K.

L.

M.

N.

Introduction and survey description

Data collection and processing procedures

References

Tape position index

Sociodemographic data - sample person

Sociodemographic data - head of family

Family composition and income data

Residence and household data

Sample weights

Family relationships

Adult history data (diabetes)

Glucose challenge questionnaire data

Plasma glucose values and computed time intervals

Notes

E@@

1

8

17

19

22

30

33

36

39

40

41

45

49

51

1

SECTION A. INTRODUCTION AND SURVEY DESCRIPTION

The National Center for Health Statistics (NCHS) collects, analyzes, anddisseminates data on the health status of Americans. The results of surveys,analyses, and studies are made known primarily through publications and therelease of computer data tapes. This document contains details required toguide programmers, statistical analysts, and research scientists in the use of aPublic Use Data Tape.

From 1960 through 1980 NCHS conducted five population-based, national healthexamination surveys. Each survey involved collecting data by direct physicalexamination, the taking of a medical history, and laboratory and clinical testsand measurements. Questionnaires and examination components have beendesigned to obtain and support analyses of data on certain targeted conditionssuch as diabetes, hypertension, and anemia. Beginning with the first NationalHealth and Nutrition Examination Survey (NHANES 1) a nutrition component wasadded to obtain information on nutritional status and dietary practices. Thenumbers of Hispanics in these samples were, however, insufficient to enableadequate estimation of their health conditions. From 1982 through 1984 aHispanic Health and Nutrition Examination Survey (HHANES) was conducted toobtain data on the health and nutritional status of three Hispanic groups:Mexican Americans from Texas, Colorado, New Mexico, Arizona, and California;Cuban Americans from Dade County, Florida; and Puerto Ricans from the NewYork City area, including parts of New Jersey and Connecticut.

The general structure of the HHANES sample design was similar to that of theprevious National Health and Nutrition Examination Surveys. All of thesestudies have used complex, multistage, stratified, clustered samples of definedpopulations. The major difference between HHANES and the previous surveys isthat HHANES was a survey of three special subgroups of the population inselected areas of the United States rather than a national probability sample. Adetailed presentation of the design specifications is found in Chapter 5 of “Planand Operation of the Hispanic Health and Nutrition Examination Survey, 1982-84” (Ref. No. 1).

Data collection began with a household interview. Several questionnaires wereadministered:

o A Household Screener Questionnaire (HSQ), administered at eachselected address, for determining household eligibility and forselecting sample persons.

o A Family Questionnaire (FQ), administered once for each familycontaining sample persons, which included sections on familyrelationships, basic demographic information for sample persons andhead of family, Medicare and health insurance coverage,participation in income assistance programs, and housingcharacteristics.

o An Adult Sample Person Questionnaire (ASPQ), for persons 12through 74 years which, depending on age, included sections on healthstatus measures, health services utilization, smoking (20 through 74years), meal program participation, and acculturation. Informationon the use of medicines and vitamins in the past two weeks was alsoobtained.

o A Child Sample Person Questionnaire (CSPQ), for sample persons 6months through 11 years which included sections on a number ofhealth status issues, health care utilization, infant feeding practices,participation in meal programs, school attendance, and language use.Information on the use of medicines and vitamins in the past twoweeks was also obtained.

2

At the Mobile Examination Center two questionnaires were administered and anexamination performed:

o An Adult Sample Person Supplement (ASPS), for sample persons 12through 74 years, which included sections on alcohol consumption,drug abuse, depression, smoking (12 through 19 years), pesticideexposure, and reproductive history.

o A Dietary Questionnaire (D Q), for persons 6 months through 74 years,by which trained dietary interviewers collected information about“usual” consumption habits and dietary practices, and recorded foodsconsumed 24-hours prior to midnight of the interview.

o An examination which included a variety of tests and procedures.Age at interview and other factors determined which procedureswere administered to which examine es. A dentist performed a dentalexamination and a vision test. Technicians took blood and urinespecimens and administered a glucose tolerance test, X-rays,electrocardiograms, and ultra monographs of the gallbladder.Technicians also performed hearing tests and took a variety of bodymeasurements. A physician performed a medical examinationfocusing especially on the cardiovascular, gastrointestinal,neurological, and musculoskeletal systems. The physician’simpression of overall health, nutritional and weight status, and healthcare needs were also recorded. Some blood and urine specimenanalyses were performed by technicians in the examination center;others were conducted under contract at various laboratories.

Because the HHANES sample is not a simple random one, it is necessary toincorporate sample weights for proper analysis of the data. .These sampleweights are a composite of individual selection probabilities, adjustments for.noncoverage and nonresponse, and posts gratification adjustments. The HHANESsample weights, which are necessary for the calculation of point estimates, arelocated on all data tapes in positions 184-213. Because of the complex sampledesign and the ratio adjustments used to produce the sample weights, commonlyused methods of point and variance estimation and hypothesis testing whichassume simple random sampling may give misleading results. In order to provideusers with the capability of estimating the complex sample variances in theHHANES data, Strata and Pseudo Primary Sampling Unit (PSU) codes have beenprovided on all data tapes in positions 214-217. These codes and the sampleweights are necessary for the calculation of variances.

There are computer programs available designed for variance estimation forcomplex sample designs. The balanced repeated replication approach(Ref. No. 2) is used in &REPERR and a linearization approach is used in&PSALMS to calculate variance-covari ance matrixes. Both routines areavailable within the OSIRIS IV library (Ref. No. 3). SURREGR (Ref. No. 4) andSUP ERCARP (Ref. No. 5) are programs that calculate variance-c ovariancematrixes using a linearization approach (Ref. No. 6) (Taylor series expansion).Another program, SE SUDAAN (Ref. No. 7) calculates standard errors, variances,and design effects. (Note: This version of SESUDAAN should not be used toobtain variances for total s.) SURREGR and SE SUDAANwhich run data under the SAS system (Ref. No. 8).

are special procedures

3

Even though the total number of examined persons in this survey is quite large,subclass analyses can lead to estimates that are unstable, particularly estimatesof variances. Consequently, analyses of subclasses require that the user payparticular attention to the number of sample persons in the subclass and thenumber of PSU’S that contain at least one sample person in the subclass. Smallsample sizes, or a small number of PSU’S used in the variance calculations, mayproduce unstable estimates of the variances.

A more complete discussion of these issues and possible analytic strategies forexamining various hypotheses is presented in Chapter 11 of “Plan and Operationof the Hispanic Health and Nutrition Examination Survey, 1982-84” (Ref. No. 1)and in an earlier NCHS methodology (Series 2) publication (Ref. No. 9).

Some users, however, may not have access to the computer programs forestimating complex sample variances or may want to do their preliminaryanalyses without using them. In addition, variance estimates calculated fromHHANES data through use of the programs described previously are likely to beunstable because there were so few sample areas for each portion of HHANES.This instability is not due to there being too few people in the sample but may bedue to the fact that the sample was selected from relatively few areas.Therefore, the following discussion is designed to provide an alternativeapproach to deal with the unavailability of software and the small number ofPsu’s. The approach is based on using average design effects (Ref. No. 10).

The design effect, defined as the ratio of the variance of a statistic from acomplex sample to the variance of the same statistic from a simple randomsample of the same size, that is,

COMPLEX SAMPLE VARIANCEDESIGN EFFECT (DEFF) ❑

SIMPLE RANDOM SAMPLE VARIANCE

is often used to show the impact of the complex sample design on variances. Ifthe design effect is near 1, the complex sample design has little effect on thevariances and the user could consider assuming simple random sampling for theanalysis.

Some illustrative design effects for HHANES data on this tape are given in thefollowing tables. The design effects in the tables are the average for the agegroups usually presented in NCHS Series 11 publications. If the average designeffect for a subgroup was less than 1.0 (implying an improvement over simplerandom sampling), it was coded as 1.0.

The following guidelines were used in the calculation of the average designeffects:

Exclude all persons of non-Hispanic origin,;: Exclude all estimates for large age ranges, such as all ages combined

or ‘all adults’, and3. Exclude all estimates where the proportion of the subpopulation with

the specific characteristic or condition was zero percent or onehundred percent.

Design effects tend to be larger when age groups are combined, just as they arewhen the sexes ,are combined, as shown in the tables. The data in the tables givethe user an idea of the range in design effects for selected response variablesfrom this data tape. If a response variable is not one shown in the tables takethe range into account; it is possible that a user could have one of the higher,rather than one of the lower, design effects.

4

Average Design Effects, by Sex, for Selected Variables --

Mexican-American Portion

Variable Mean or Tape Both Male FemaleProportion Positions Sexes

Do you have diabetesor sugar diabetes?

Have you been told bya doctor or healthprofessional that youhave borderline diabetes?

Have you been told bya doctor or healthprofessional that youhave potential diabetes?

Have you ever takeninsulin injections?

Have you ever takendiabetes pills?

Plasma glucose value fromfirst venipuncture

Plasma glucose value fromthird venipuncture

Interval between lastfood or drink and firstvenip-uncture

P

P

P

405

412

415

430

438

517-519

523-525

526-529

1.0 1.0 1.0

1.1 1.1 1.0

1.0 1.0 1.0

1.1 1.0 1.0

1.0 1.0 1.0

1.5 1.3 1.6

2.0 1.4 1.7

1.2 1.1 1.0

Source: NCHS, HHANES, 1982-84, Tape Number 6506, Version 1.

5

Average Design Effects, by Sex, for Selected Variables --

Cuban-American Portion


Do you have diabetes P 405 1.1 1.0 1.1or sugar diabetes?

Have you been told by P 412 1.1 1.2 *

a doctor or healthprofessional that youhave borderline diabetes?

Have you been told by P 415 1.1 1.2 1.1a doctor or healthprofessional that youhave ~otential diabetes?



Plasma glucose valuefirst venipuncture

Plasma glucose valuethird venipuncture

Interval between last

P 430 1.0 * *

P 438 1.0 * *

from ; 517-519 1.0 1.1 1.0

from ? 523-525 1.1 1.3 1.0

? 526-529 1.0 1.0 1.0food or drink and firstvenipuncture


*These are samples of variables where the number of sample persons with apositive response was too small to calculate reliable age-sex specific populationestimates, variances of those estimates, and average design effects, For this datatape, there may be many variables (e. g., questions asked only of diabetics) wherethis is the case.

6

Average Design Effects, by Sex, for Selected Variables --Puerto Rican Portion


Do you have diabetesor sugar diabetes?

Have you been told bya doctor or healthprofessional that youhave borderline diabetes?

Have you been told bya doctor or healthprofessional that youhave potential diabetes7



Plasma glucose value fromfirst venipuncture

Plasma glucose value fromthird venipuncture

Interval between lastfood or drink and firstvenipuncture

P

P

P

405

412

415

430

438

517-519

523-525

526-529

1,0 1.3

1.1 *

1.5 1,8

1.0 *

1.0 *

1.1 1.1

1.5 1.3

1.2 1.2

1.2

1.2

1.0

*

*

1.0

1.3

1.0


*These are samples of variables where the number of sample persons with apositive response was too small to calculate reliable age-sex specific populationestimates, variances of those estimates, and average design effects. For this datatape, there may be many variables (e.g., questions asked only of diabetics) wherethis is the case.

Suppose, for example, that of the 177 Puerto Rican females ages 45-54 years,11.7 percent reported that they have diabetes or sugar diabetes. Suppose, also,that their mean plasma glucose value at third venipuncture was 134.5.

Assuming simple random sampling, the variance for the percent is calculated byconverting the percent to a proportion and using the standard formula for thevariance of a proportion,

This variance (V) multiplied by the design effect (DEFF) provides an estimate ofthe variance from a complex sample of the same sample size (n). In the exampleabove,

(.1 17) (.883)v=

177

= .00058 = variance for a simple random sample

Then, multiplying by the design effect,

= (.00058) (1.2)

= .0007 = estimated variance for the complex sample

In a similar way, the complex sample variance of the mean plasma glucose at thethird venipuncture is determined by multiplying the simple random samplevariance of the mean by the appropriate design effect -- in this example, 1.3.

The user can then proceed with estimating confidence intervals and testinghypotheses in the usual manner.

.

The user should recognize that this approach does not incorporate the variancecovariance matrix. In most cases, this leads to a slight overestimate of thevariance because the covariance terms, which are subtracted in the variance of aratio, in general are positive. Thus, in a borderline case, thewould be less likely to be rejected (Ref. No. 11).

Alternative or better approaches may exist or be developed.suggest such approaches, or who want the latest informationScientific and Technical Information Branch (address given inthis documentation).

null hypothesis

Users who want toshould contact thethe beginning of

SECTION B. DATA COLLECTION AND PROCESSING PROCEDURES

General Procedures

Data presented in Sections E through H and the family relationships data inSection J were collected on the Household Screener and Family Questionnaires.Data presented in Section K were collected on the Adult Sample PersonQuestionnaire. These interview schedules were administered in sample persons’households. Data presented in Sections L and M were collected in the mobileexamination center. Completed interview schedules were reviewed in theSurvey’s field offices and again at the data processing center of NCHS byclerical editors. The editors checked the forms for completeness, clarity, andcompliance with skip patterns, and they coded items such as industry andoccupation. At the data processing center the questionnaires were keyed andverified on key-to-disk data entry equipment under the control of programs thatchecked for valid codes and ranges, compliance with skip patterns, andconsistency. After being keyed, data were reedited by analysts forreasonableness and consistency and for compliance with instructions for samplingand questionnaire administration.

The general tape description format is Tape Position X Item X Counts. The item(field) may be a tape descriptor (e.g. Version Number), a sample persondescriptor (e.g. Age at Interview), or a question (e.g. Is sample person covered byMedicare?). Where appropriate, data entries are presented by codes. Frequencycounts are given for each code. The counts are included to help the user inplanning analyses and in verifying that programs account for all data. The datasource is given also (e. g., from Family Questionnaire). In some cases, a note isreferenced. The notes contain explanations of the item (e.g. how Poverty Indexis calculated).

The questionnaire data have undergone many quality control and editingprocedures. The responses of sample persons to some questions may appearextreme or illogical. Self-reported data, especially, are subject to a number ofsources of variability, including recall and other reporting errors. In the dataclean-up process, responses that varied considerably from expected wereverified through direct review of the collection form or a copy of it. Suchresponses may not represent fact, but they are included as recorded in the field.The user must determine if these responses should be included in analyses.

Responses to “other” and “specify” were recoded to existing categories, ifpossible. For responses that could not be recoded, new code categories werecreated if the information was deemed analytically useful. Caution should beused in interpreting the data from these new categories because there is no wayof knowing which other respondents would have selected one of the newcategories if given the option.

For the adult sample person questionnaires there are three codes for missinginformation: 7’s, 8’s, and blanks. In a few questions, 7’s were used when thequestion was not applicable. A code “8”, which is labeled as “blank butapplicable”, is used to indicate that a sample person should have a data value fora particular item but for varying reasons that value is unavailable. Blanks wereused to follow skip patterns, i.e., when a question was not supposed to be askedor was not applicable. The “don’t know” codes (9, 99, 999) were used only whengiven as a printed response on the original questionnaire.

Copies of the questionnaires, both in English and in Spanish, can be found in thepIan and operation report for HHANES (Ref. No. 1). Detailed information oninterviewing procedures is contained in the household interviewer’s manual(Ref. No. 12) and the mobile examination center interviewer’s manual(Ref. No. 13). These manuals are available upon request from:

Division of Health Examination StatisticsNational Center for Health StatisticsCenter Building, Room 2-583700 East-West HighwayHyattsville, MD 20782301-436-7080

10

OGTT Procedures and Bias Analysis

The oral glucose tolerance test (OGTT) was administered to a subsample ofadults aged 20-74 years who are referred to as the fasting subsample. Thissubsample was selected by assigning alternative sample persons aged 20-74to a one-half subsample who were asked to fast overnight, to attend the

years

examination center in” the morning, and, with the exception of diabetics usinginsulin, to submit to an OGTT. There were 2554 Mexican-Americans, 782 Cuban-Americans, and 979 Puerto Ricans aged 20-74 years in the fasting subsamples.

Oral glucose tolerance tests were administered to this subsample according tothe National Diabetes Data Group’s (NDDG) recommendations (Ref. No. 14),which require the following: subjects must fast overnight for 10-16 hours; OGTT’Sare performed in the morning; a fasting blood sample is taken; subjects drinkflavored water containing 75 grams of glucose or carbohydrate equivalent;additional blood samples are taken after one hour and two hours, This procedurewas utilized in the second National Health and Nutrition Examination Survey(NH.ANES 11), 1976-1980, and has been described in more detail in Ref. No. 15. Inthat survey, OGTT’S that conformed to the NDDG’s requirements wereobtainable from only 43 percent of persons in the OGTT subsample.

As shown in Table A, the response rates to the OGTT in the HHANES were alsolow: 39.6 percent for Mexican-American adults, 27.1 percent for Cuban-American adults, and 27.8 percent for Puerto Rican adults in the adult fastingsubsample. A large proportion of the non-response occurred from refusals forthe overall interview and examination and not the OGTT per se. One should alsoexamine the response rates among the adults in the fasting subsample who wereeligible for the OGTT (interviewed, examined, and not a diabetic on insulin).Using the latter as the denominator, the response rates to the OGTT were 58.1percent (1012/1741), 47.4 percent {212/447), and 42.0 percent (272/647) in theMexican-American, Cuban-American, and Puerto Rican samples, respectively.The low response rates were primarily explained by failure to meet theexamination requirements to fast before the exam and failure to attend theexamination center in the morning hours. Although the initial fastingrequirements were between 10 and 16 hours before the exam, we extended thoselimits to 9 and 17 hours for analysis purposes.

In the previous analysis of the non-response to the OGTT in NHANES 11, severalchecks were made to detect non-response bias in the OGTT results (Ref. No. 14).Using the previous approach as a model, we took the following steps to evaluatepotential bias from the high non-response to the OGTT:

1.

2.

3,

Convened a distinguished panel of experts to advise the Center on theacceptability of the OGTT data, the NCHS Diabetes Working Group, SeeTable B for names and affiliations.

Compared frequency distributions on several demographic, socioeconomic,and medical variables from the completed OGTT sample persons with theentire interviewed sample, the entire examined sample, and the non-completed OGTT sample. These variables are shown in Table C.

Computed statistical tests for differences between the completedOGTT sample and the non-completed OGTT sample for the variablesexamined in Table C.

U

4. Evaluated some possible effects of non-response on the prevalenceestimates of diabetes in the OGTT examined group by computing andcomparing observed and expected rates of diabetes and impaired glucosetolerance. The criteria for these diagnoses are shown in Table D. Theexpected rates were the rates one would expect in the entire OGTT sampleif all eligible persons had taken the test. These were computed, using thedirect method of standardization, by multiplying the prevalence rates ofdiabetes for each group of demographic or medical variables in thecompleted OGTT sample times the population distribution of the entireOGTT sample in each subgroup of the variables examined. Expected ratesof diabetes were then computed by adding the rates for each subgroup. Anexample is shown below:

For the Mexican-American sample, the prevalence rates of the World HealthOrganization (WHO) diabetes by age times proportion of each age group inentire OGTT sample is:

20 - 44 years, .0215 (prev. rate) X .628 (proportion in OGTT

45 - 74 years, .1404 (prev. rate) X .372 (proportion in OGTT

Expected rate of diabetes taking ageOGTT sample into account

sample) = .0135

sample) ❑ +.0522.0657

of or 6.57°A

6.57% is similarsample (6.799fo).undiagnosed) inon insulin were

to the observed rate of diabetes in the OGTT-completed(Note: This is not the true rate of diabetes (diagnosed and

the Mexican-American sample since self-reported diabeticsnot included in the OGTT sample.

5. The observed rates of diabetes were divided by the expected rates ofdiabetes (0/E) for each demographic and medical variable noted above. IfO/E was > 1.1 or < .9, the variable was said to be biased. [n other words,bias was said to be detected if the rates observed in the completed OGTTsample were 10 percent higher or lower relative to the expected rates basedon the entire OGTT sample.

The results of the above analyses were unremarkable. For the Mexican-American sample, there were no significant differences on any of thevariables shown in Table C between the completed OGTT and non-completedOGTT sample persons. Likewise, the O/E ratios for WHO diabetes and WHOIGT were all within the limits of acceptability set by the NCHS DiabetesWorking Group.

In the Cuban-American analyses, there was only one variable with asignificant difference. The completed OGTT sample was more likely tohave non-smokers (56.5%) than the non-completed sample (45.3%). Becausethis effect could have resulted from age, the analyses were rerun controllingfor age (45+) and the variables noted in Tabie C. NO significant differenceswere observed between the completed and non-completed OGTT samples,and all O/E ratios for WHO diabetes and WHO IGT were within theacceptable limits.

We

For the Puerto Rican analyses, the completed OGTT sample was older (50.0vs 38.8% over age 45 responding) and in fair or poor self-reported health(54.8 vs 47,8%, respectively) than the non-completed sample. Since therewere only two persons with diabetes in the 20-44 age group, the analyseswere rerun for persons 45-74 years, wherein the health status differencedisappeared. One additional variable appeared as different in this age groupwhen examining O/E ratios; wearing glasses or contacts (greater proportionin completed OGTT sample). However, the statistical test was deemedinvalid because of a zero cell. All the diagnosed diabetics in the “completedsample wore glasses, thus, no diabetics were free of glasses. Likewise,education became important for IGT in the O/E analysis because all thesample persons diagnosed with IGT were lower educated (less than highschool). In summary, there was no discernible bias in the observed rates ofWHO diabetes or WHO IGT in the Puerto Rican sample, after taking age andsmall sample sizes into account.

should note one final word of caution. There may have been some othervariable, not collected in HHANES, that affected the completion rate for theOGTT and that could bias the diabetes rates. For example, in the NHANES IIsurvey (Ref. No. 15), participation in the OGTT was higher among persons with aparent who had had diabetes as compared to those persons who had no parentalhistory of diabetes. Since this question was not asked in HHANES, we cannot saywhether or not this factor caused selection bias. We do know, however, that thisvariable was found to cause a difference of only .4% in the diabetes prevalenceestimates for the persons in NHANES II - making it unlikely to affect estimatescomputed for HHANES (Ref. No. 15) in a major way. Researchers shouldcarefully evaluate the potential nonresponse bias for any analyses they performwith these data.

13

TAELE A

Response Rates for OGTT

Mexican-Americans Cuban-Americans Puerto Rlcans

% of % of % ofResponseCategory Number Total Number Total Number Total

Total Adult 2554 100,0 782 100.0 979 100,0Fasting Sample

Interviewed 2120 83.0 595 76.1Sampl e

842 86.0

Examined 1777 69.6 449 57.4 667 68.1Sampl e

Examined but 22 2 20ineligible forOGTT beta-iseof current insul inuse

Three plasma glucose 1012 39.6 212 27.1 27.2 27.8values obtained

14

TABLE E

Names ar!d affiliations of NCHS panel convened to evaluate HHANES OGTT data:

Name Afflllatlon

Maureen I. Harris, Ph.D. Nat Tonal Diabetes Data GroupNIDOK, National Institutes of HealthBethesda, Maryland

Rumaldo Juarez, Ph.0, Department of Sociology and Social WorkPan American UniversityEdinburg, Texas

William C, Knowler, M.D., Dr.P,H. Epidemiology and Field Studies BranchNIDDK, National Institutes of HealthPhoenix, Arizona

Eliseo J, Perez-Stable, M,O. Olvislofl of General Internal MedlclneDepartment of MedicineUnlverslty of CaliforniaSan Francisco. California

Michael P, Stern, M.O Dlvlslon of Cllnical EpidemiologyDepartment of MedicineUnlverslty of Texas Health Science CenterSan Antonio, Texas

National Center for Health Statistics Staff from the Divisionof Health Examination Statistics

.

Trena M, Ezzatl, M.S. Survey Planning and Development Branch

Katherine M. Flegal, Ph.O. Medical Statistics Branch

Marilyn Miles McMillen, Ph.D. Medical Statistics Branch

Suzanne G. Haynes, Ph.D. Medical Statistics Branch

I-5

TABLE C

Variables Examined In the HHANES OGTT Elas Analysis

Type of Variable Variable Name Questlonnalre orExamlnatlon”

Sociodemographlc AgeSexGenerationMarital StatusEducationPoverty IndexLiteracyAcculturation (for

Mexican-Amer icans

Life-St/le Characteristics

Health Care

Health Status or Conditions

HSQFQASPQFQFQFQASPQASPQ

only)

Overweight AnthropometrlcExam

Current Smoker ASPQEver Smoked ASPQ

Ever had Routine Exam ASPQHave a Usual Place of ASPQ

Health CareHad Health Care in ASPQ

Previous YearsHas Health Insurance ASPQLast Vlslt to Usual ASPQ

Place of CareLast Visit to Any ASPQ

Place of CareWears Glasses or Contacts ASPQ

Self-reported Health StatusDoctor or Health Professional

Diagnosed Eorderl lne, Potential.or Pre-diabetes

Ooctor or Health ProfessionalDiagnosed Hypertension

On Medication for HypertensionDoctor ever told:

Rheumatic FeverRheumatic Heart DiseaseHeart MurmurHeart FailureHeart AttackKidney ProblemsGlaucomaCataracts

ASPQASPQ

ASPQ

ASPQ

ASPQASPQASPQASPQASPQASPQASPQASPQ

“HSQ = Household Screener QuestionnaireFQ = Family (QuestionnaireASPQ = Adult Sample Person Questionnaire

16

TABLE D

World Health Organization Crlterla used to define diabetes or impaired glucosetolerance using results from the OGTT

Fasting and 2-hourPlasma GlucoseConcentrations Diagnosis

Fasting, 140 mg/dl or more Diabetes

Fasting. less than 140 mg/dl :2 hour, 200 mg/dl or more Diabetes2 hour, 140-199 mg/dl Impaired Glucose Tolerance

2 hour, less than 140 mg/dl Normal

17

SECTION C. REFERENCES

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

National Center for Health Statistics: Maurer, K. R. and others: Plan andOperation of the Hispanic Health and Nutrition Examination Survey,1982-84. Vital and Health Statisti~s. Series 1, No. 19. DHHS Pub. No.(PHS) 85-1321. Public Health Service. Washington. U.S. GovernmentPrinting Office. Sept., 1985.

National Center for Health Statistics: McCarthy, P. J.: Replication: AnApproach to the Analysis of Data from Complex Surveys. Vital and HealthStatistics. Series 2, No. 14. PHS Pub. No. 1000. Public Health Service.Washington. U.S. Government Printing Office. Apr., 1966.

Survey Research Center Computer Support Group: OSIRIS IV User’sManual, Institute for Social Research, University of Michigan, Ann Arbor,Ml, 1979.

Ho It, M. M: SURREGR: Standard Errors of Regression Coefficients fromSam~le Survey Data. Research Triangle Institute, Research Triangle Park,NC, 1977. (Revised Apr., 1982 by B. V. Shah).

Hidiroglou, M, A., Fuller, W. A., and Hickman, R. D.: SUPERCARP. SixthEdition. Survey Section, Statistical Laboratory, lowa State University,Ames, 1A. Oct., 1980.

Woodruff, R. S.: A Simple Method for Approximating the Variance of aComplicated Estimate. Journal of the American Statistical Association,66:411-414, 1971.

Shah, B. V.: SESUDAAN: Standard Errors Proqram for Computing ofStandardized Rates from Sample Survev Data. RT1/5250/00-OIS. ResearchTriangle Institute, Research Triangle Park, NC, Apr., 1981.

SAS Institute Inc. SAS User’s Guide: Basics. Version 5 Edition.SAS Institute Inc., Cary, NC. 1985.

National Center for Health Statistics: Landis, J. R., Lepkowski, J. M.,Eklund, S. A., and Stehouwer, S. A. A Statistical Methodology forAnalyzing Data from a Complex Survey: The First National Health andNutrition Examination Survey. Vital and Health Statistics. Series 2, No.92. DHHS Pub. No. (PHS) 82-1366. Public Health Service. Washington.U.S. Government Printing Office. Sept., 1982.

Kovar, M. G. and Johnson, C.: Design Effects from the Mexican-AmericanPortion of the Hispanic Health and Nutrition Examination Survey: AStrategy for Analysts. Proceedings of the Social Statistics Section,American Statistical Association, 1986.

Freeman, D. H. and Brock, D. B.: The Role of Covariance MatrixEstimation in the Analysis of Complex Sample Survey Data. In N.Krishnan Namboodiri, cd., Survey Sam~linq and Measurement. Symposium‘on Survey Sampling, 2d, University of North Carolina. New York,Academic Press, 1978.

National Center for Health Statistics: Instruction Manual Part 15h,Household Interviewer’s Manual for the Hispanic Health and NutritionExamination Survey, 1982-84. Hyattsville, MD, 1986.

National Center for Health Statistics: Instruction Manual Part 15g, MobileExamination Center Interviewer’s Manual for the Hispanic Health andNutrition Examination Survey, 1982-84. Hyattsville, MD, 1986.

18

SECTION C. REFERENCES

I4. National Diabetes Data Group: Classification and Diagnosis of DiabetesMellitus and Other Categories of Glucose Intolerance. Diabetes 28:1039 -1059, 1979.

I5. National Center for Health Statistics: Hadden, W.C. and Harris, M. I.:Prevalence of Diagnosed Diabetes, Undiagnosed Diabetes, and ImpairedGlucose Tolerance in Adults. Vital and Health Statistics. Series 11, No.237. DHHS Pub. No. (PHS) 87-1687. Public Health Service. Washington.U. S. Government Printing Office, Feb. 1987.

19

SECTION D. TAPE POSITION INDEX

TAPE POSITIONS 1-400 contain data categories common to all data tapes:sociodemographic data, family composition, family income, residence andhousehold. Sample weights are also in this set of data.

TAPE POSITIONS 401+ contain data categories unique to this data -tape.

SOCIODEMOGRAPHIC DATA - sAMpLE PERSON (SECTION E)

1-56-15

1617

18-2122-2526-2930-3233-3839-4344-45

4647

48-4950-52

5354-56

5758

59-6970-9596-99

Sample Person Sequence NumberSurvey and Tape IdentifiersExamination StatusLanguage of InterviewDate of InterviewDate of ExaminationDate of BirthAge at InterviewAge at ExaminationFamily NumberRelationship to Head of FamilySexRaceNational Origin or AncestryBirth PlaceNational Origin RecodeEducationMarital StatusService in Armed ForcesWork/Occupation/EmploymentHealth Insurance/Health Care SupportIncome Assistance/Public Compensation or Support

SOCIODEMOGRAPHIC DATA - HEAD OF FAMILY (SECTION F)

100 Interview and Examination Status102-105 Date of Birth106-108 Age at Interview

109 Sex110 Race

111-112 National Origin or Ancestry113-115 Birth Place116-118 Education

119 Marital Status120 Service in Armed Forces

121-131 Work/Occupation/Employment

●

20

FAMILY COMPOSITION AND INCOME DATA (SECTION G)

132-133 Number of People in Family134-135 Number of Sample People in Family136-138 Combined Family Income139-143 Per Capita Income144-146 Poverty Index147-162 Income, Food Stamps

RESIDENCE AND HOUSEHOLD DATA (SECTl ON H)

163 Size of Place164 Standard Metropolitan Statistical Area

165-166 Number of People in Household167-168 Number of Sample People in Household169-170 Number of Rooms

171 Kitchen Facilities Access172-183 Heating/Cooling Equipment

SAMPLE WEIGHTS (SECTION 1)

184-189 Examination Final Weight190-195 Interview Final Weight196-201 GTT/Ultrasound Weight202-207 Audiometry/Vision Weight208-213 Pesticide Weight214-215 Strata Code216-217 Pseudo PSU Code

FAMILY RELATIONSHIP.5 (sECTION J)

218-400 Data not yet available

ADULT HISTORY DATA (DIABETES) (SECTION K)

405406-407408-411412-420422-424425-426427-429430-437438-443444-445

446447-448

Self-Reported DiabetesSource of Diabetes DiagnosisAge of Diabetes OnsetSelf-reported Borderline, Potential, and PrediabetesTests for DiabetesHospitalization for DiabetesWeight at DiagnosisInsulin TreatmentDiabetes PillsDiet for DiabetesIdentificationLast and Annual Health Visits

21

GLUCOSE CHALLENGE QUESTIONNAIRE DATA (SECTION L)

450-453454455

456-457458

459-460461-462463-467468-473474-479480-496

Tape NumberIn Fasting SubsampleOGTT Completion StatusReason for Incomplete OGTTSecond Visit StatusReason for Second VisitOn Diabetes MedicationLast MealLast Anything to EatLast Anything to DrinkSecond Visit Information

PLASMA GLUCOSE VALUES AND COMPUTED TIME INTERVALS (SECTION M)

500-503 Time of First Venipuncture504-507 Time Glucola Given508-511 Time of Second Venipuncture512-515 Time of Third Venipuncture

516 Time Generated517-525 Plasma Gluose Values526-569 Computed Time Intervals

TAPE 6506 22

Position Item description Counts Sourceand code M c P and notes

SECTION E. SOCIODEMOGRAPHIC DATA - SAMPLE PERSON (POS 1-99)5ource: Family Questionnaire (FQ)

1-5

6-12

13

14

17

18-1920-21

22-2324-25

26-27

28-29

30-31

32

Household Screener Questionnaire (HSQ)

Sample person sequence number00001-09894 Mexican Americans10002-12238 Cuban Americans13001-16785 Puerto Rlcans

B 1ank

Portion of surveyf Mexican-American (M)2 Cuban-American (C)3 Puerto Rican (P)

Family Questionnaire missing1 Yes2 No

Version number1

Examination status1 Examined2 Not examined

Language of interview (Pos. 1-400)1 Engl ish2 Spani shBlank

Date of interview01-12 Month82-04 Yeav

Date of examinationFrom survey control record01-12 Month82-84 Year

Date of birth01-12 Month88 Blank but08-64 Year88 Blank but

Age at interview20-74 (See next

Age at interview1 Years

wp

app

cab

cab

e

e

(computed)column for units)

units

3555907

1353

3555907

1353

10 4 5 See Note 13545 903 1348

3555 907 1353

3555 907 1353 See Note 20 0 0

FQ2127 157 5611418 746 787

10 4 5

HSQ 43555 907 13533555 907 1353

3555 907 1353

3555 907 1353

HSQ 2e3555 907 1353

0 0 03555 907 1353

0 0 0

3555 907 1353”

HSQ 2f3555 907 ~353

TAPE 650623

Posltlon Item description Counts Sourceand code M c P and notes

Age at examination (computed)Posltlons 33-38 are all O fornon-examined persons.

33-34 20-75 ‘Years35-36 00-11 Llonths37-38 00-30 Days

355535553555

907 1353907 1353907 1353

See Note 3

9071353

39-43 Family number00002-0352704005-0492207003-0s584

3555

J,.a--l5 What is sample person’s relationship to H5Q 2bSee Note 4

113head of fam”ily?” Sample person is:01 Head of family Iivlng a

with only 1 member)02 Head of family, with no

persons In householdIn household)

03 Head of family, with reIn household

04 Wife of head (husband llvand not In Armed Forces

05 Wife of head (husband 1 ivand is in Armed Forces)

06 Husband of head (wife 1 ivand not In Armed Forces

07 Husband of head (wife livand 1s In Armed Forces)

08 Child of head or head’s spouse09 Grandchild of head or head’s spouse10 Parent of head or head’s spouse11 Other relatlve (includes ex-spouse,

daughter-in-law. etc.)12 Foster child

143

70

56

23

one (1 family

related2+ persons

ated persons

23

1566 368 674

ng at home

ng at home

ng at home

ng at home

297 2901264

5 0 0

1235 37

0 0 0

762777

57131

1263

3354

03540

00 0

46 Sex1 Male2 Female

FQ B--l498855

393514

15721983

FQ B-51220 See Note 5

62272811

5

47 Observed race1 White2 Black3 Other8 Blank but applicable9 Not observedBlank

87013

212

G4

344630

G412210

48-49 Sample person’s national originor ancestry.01 Mexican/Mexi cano02 Mexican-American03 Chicano

04 Puerto Rican05 Boricuan06 Cuban07 Cuban-American0s Hispano - specify09 Other Latin-American or other

Spanish - specify00 Other - specify10 Spanish-American11 Spanish (Spain)

HSQ 2CSee Note 6

1 10 00 03 1202

0 15796 14

69 010 2016 25

9402230

467

030

6125

2171313

12 76

0 00 0

TAPE 6506


50-52

53

54-55

56

57

58

59

In what state or foreign country was sampleperson born?001-115 State/country code888 Blank but applicableB1 ank

35281710

90034

FQ B-6

132424

5

See Note 8norldaty area.

3326 865 1220229 42 133

FQ B-7

National origin recode“HTspanic” = Mexican-AmericanSouthwest, Cuban-American in Fand Puerto Rican in New York C

1 ‘(Hispanic”2 Not “Hispanic”

What is the highest grade or year of regularschool sample person has ever attended?00 Never attended or kindergarten only01-08 Elementary grade09-12 High school grade13-16 Col lege17 Graduate school88 Blank but applicableBlank

Did sample person finish that grade/year?1 Yes2 No8 Blank but applicable01 ank

Is sample person now married, widowed,divorced, separated or has he or shenever been married?1 Married - spouse In household2 Married - spouse not In household3 Wldoweci4 Divorced5 Separated6 Never married8 Blank but applicable01 ank

Did sample person ever serve in the ArmedForces of the United States?1 Yes2 No8 Blank but applicableBlank

During the past 2 weeks, did sample personwork at any time at a job or business, notcounting work around the house?1 Yes2 No8 Blank but applicableBlank

14113121442536

694510

2779580

45

151

6342292228

3054

779108

1010

23435666195

1415

5

FQ B-81055

2363428

FQ B-9

2539 622 6d768 17 53

161209149403

1610

50 6692 15421 147

100 2751 64 5

FQ B-11 ‘

413 27 1413125 874 1198

7 2 910 4 5

F(J B-12

20281507

1010

581317

54

566767

155

TAPE 6506 25


60 Even though sample person did not workduring those 2 weeks, did he or she havea jab or business?1 Yes2 No8 Elank but applicableEl ank

FQ B-13

44 12 211462 303 743

11 7 182038 585 571

61 Was sample person looking for work or onlayoff from a job?1 Yes2 No8 Blank but applicableBlank

FO B-l-1

200 39 511306 276 713

11 7 18203S 505 571

62 Which, looking for work or on layofffrom a job or both?1 Looking2 Layoff3 BothBlank but applicableBlank

FQ B-15

131452213

3344

30 356 a2 78 19

861 1284

63-65 What kind of business or industry doessample person work for?010-932 Industry code990 Blank but applicableB1 ank

FQ B-19

See Note 962~ 628

10 21276 704

223831

1286

66-68 Uhat kind of work was sample persondoing?003-889 Occupation code999 Blank but applicableE 1ank

FQ B-20See Note 9

622 62a9 21

276 704

224029

1286

69 Class of worker1 An employee of a private company,

business or Individual for wages,salary, or commission

2 A Federal government employee3 A State government employee4 A Local government employee5 Self-employed in own incorporated

business or professional practice6 Self-employed in own unincorporated

business. professional practice.or farm

7 Working without pay in familybusiness or farm

8 Blank but appl icableo Never worked or never worked at a

full-time civilian job lasting2 weeks or more

El ank

FQ B-22502 5011742

72119163

17

6 181.s 1716 5612 7

125 66 26

0 0

291

10 231 1

1286 276 704

70 Is sample person now covered by Medicare?i Covered2 Not covered8 Blank but appl icable9 Don’t knowBlank

FQ C-2103 109796 1234

3 51 04 5

2583279

53

10

TAPE 6506 26


71

72

73

74

75

76

Is sample person now covered by the part FQ C-3of Social Security Medicare which paysfor hospital bills?1 Yes2 No8 Blank but applicable9 Don’t knowBlank

230 96 10013 4 414 3 10

6 3 03292 801 1239

Is sample person now covered by that partof Medicare which pays for doctor’s bills?This is the Medicare plan for which he orshe or some agency must pay a certain amounteach month,1 Yes 227 98 922 No 14 3 118 Blank but applicable 14 3 109 Don’t know a 2 1Blank 3292 801 1239

FQ C-4

Type of Medicare coverage FQ C-5As shown on Medicare card2 Medical 2 0 03 Card not available 3 0 14 Hospital and medical 5 3 0B Blank but applicable 14 3 10Blank 3531 901 1342

HEALTH INSURANCE

Is sample person covered by any healthinsurance plan which pays any part ofa hospital, doctor’s, or surgeon’s bill?1 Yes2 No8 Blank but applicable9 Don’t knowBlank

Is sample person covered by a plan thatpays any part of hospital expenses?1 Yes2 No8 Blank but applicable9 Oon’t knowB1 ank

Is sample person covered by a plan thatpays any part of a doctor’s or surgeon’sbills for operations?1 Yes2 No8 Blank but applicable9 Don’t knowBlank

20091526

G4

10

19793

276

1540

See Note 10

FQ C-11

556 560343 779

4 90 04 5

FQ C-9

550 5253 47 350 5

347 784

FQ C-10

1982 546 5239 7 17

15 7 209 0 9

1540 347 784

TAPE 6506 27


Many people do not carry health insurancefor various reasons.

FQ C-13/15Which of these See Note 10

statements describes why sample personis not covered by any health insurance(or Medicare)? (Positions 77-8o)

77-78 Main reason01 Care received through Medicaid or

welfare02 Unemployed. or reasons related to

unemployment03 Can’t obtain insurance because of

poor health. Illness, or age04 Too expensive, can’t afford health

insurance05 Dissatisfied with previous insurance

06 Donrt believe in insurance07 Have been healthy, not much sickness

in the family, haven’t neededhealth insurance

08 Milltary dependent. (CHAMPUS),Veteran’s benefits

09 Some other reason - not specified10 Some other reason - specified88 Blank but applicableBlank

79 28914

180 29 68

17 2 9

756 163 226

23i494

23

15

24

13

20 i 11

1

11249

2210

01923

636

23729

663

79-80 Second reason00 No second reason reported01 Care received through kled~ca~d or

welfare02 Unemployed, or reasons related to

unemployment03 Can’t obtain insurance because of

poor health, illness, or age04 Too expensive, can’t afford health

i nsurance05 Dissatisfied with previous insurance06 Don’t believe in Insurance07 Have been healthy, not much sickness

in the family, haven’t neededhealth insurance

08 Military dependent, (CHAMPUS),Veteran’s benefits

09 Some other reason - not specified10 Some other reason - specified88 Blank but applicable61 ank

110225

19910

56423

46 16 12

3 1 2

81 56

87

21

213

114

0 0 0

01339

2210

06

19636

02

25663

8~-87 B1 ank

FQ D-688 During the last 12 months, has sampleperson received health care which hasbeen or will be paid for by Medicaid?1 Yes2 No8 Blank but applicable9 Don’t knowBlank

1953328

220

10

66832

504

385949

14

05

TAPE 6506 28


89

90

91

92

93

94

95

Does sample person have a Medicaid card? FQ D-81 Yes2 No8 Blank but applicable9 Don’t knowBlank

198 67 4033329 825 931

ia 11 140 0 0

10 4 5

Status of sample person’s Medicaid card?1 Medicaid card seen - current2 Medicaid card seen - expired3 No card seen4 Other card seen5 Other card seen (specify)8 Blank but applicableBlank

Is sample person now covered by any otherpublic assistance program that pays forhealth care?1 Yes2 No8 Blank but applicable9 Oon’t knowBlank

FQ O-9i4a 52 285

2 0 543 13 103

0 0 03 0 1

20 13 233339 829 936

FQ 0-11

12 2 123527 900 1331

6 1 50 0 0

10 4 5

Does sample person now receive militaryretirement payments from any branch of theArmed Forces or a pension from the Veteran’sAdministration? Do not include VA disabilitycompensate on.1 Yes 45 2 92 No 3492 900 13358 Blank but applicable 8 1 49 Oon’t know o 0 0Blank 10 4 5

Which does sample person receive; the ArmedForces retirement, the VA pension, or both?i Armed Forces2 Veteran’s Adm3 Both8 Blank but app”Blank

Is sample personwhich is medical

nlstratlon

lcable

now covered by CHAMP-VA,insurance for dependents

or survivors of disabled veterans?1 Yes2 Noa Blank but applicable9 Don’t knowBlank

12 0 224 0 5

4 2 113 1 5

3502 904 1340

FQ D-13

FQ 0-14

FQ 0-16

20 2 63520 900 1340

5 1 20 0 0

10 4 5

Is sample person now covered by any otherprogram that provides health care for militarydependents or survivors of military persons?1 Yes 20 1 52 No 351s 901 13368 Blank but applicable 7 1 79 Don’t know o 0 0B1 ank 10 4 5

FQ D-18

TAPE 65G6 29


96 Is sample person included in the AFDC,“Aid to Families with Dependent Children”,assistance payment?1 Yes2 No8 Blank but applicable9 Don’t knowB 1ank

97 Does sample person now receive the“Supplemental Security Income” or “SS1”gold-colored check?1 Yes2 No8 Blank but applicable9 Don’t knowBlank

98 Does sample person have a disabilityrelated to his or her service in theArmed Forces of the United States?1 Yes2 No8 Blank but applicableBlank

873448

10

010

923441

120

10

48343

293135

99 Does sample person now receive compensationfor this disability from the Veteran’sAdministration?1 Yes 312 No 178 Blank but applicable 29Blank 3478

15 182885 1153

2 121 14 5

43 91852 1247

8 100 04 5

FQ D-2

FQ D--l

FQ D-20

2 1420 106

7 30878 1203

FQ D-21

1 91 47 31

898 i 309

TAPE 65CJ6 30

Posit Ion Item description Counts Sourceand code M c P and notes

SECTION F. SOCIODEMOGRAPHIC DATA - HEAD OF FAMILY (POS 100-131)Source : Family Questlonnalre (FQ)

100

101

102-103

104-105

106-107

108

109

110

111-112

Household Screener Questionnaire (HSQ)

Interview and examination status of headof familv1

2

3

4B

B

Selec;ed as sample person, Interviewed 3158 764 1266on Adult Sample Person Questionnaire,and examined

Selected as sample person, Interviewed 120 32 30on Adult Sample Person Questionnaire,but not examined

Selected as sample person, not 98 21 5Interviewed, and not examined

Not selected as sample person 169 86 47ank 10 4 5

ank

Date of birth01-12 Month88 Blank but applicable00-86, 89-99 Year88 Blank but applicable

Age at interview18-95 Years

B 1 ank

Sex1 Male2 FemaleBlank

Observed race1 Whi te2 Black3 Other8 Blank but applicable9 Not observedB 1ank

Head of family’s national originor ancestry. -01 Mexican/klexicano02 Mexican-American03 Chicano04 Puerto Rican05 Bor~cuan06 Cuban

07 Cuban-AmericanOS Hispano - specify09 Other Latin-American or other

Spanish - specify00 Other - specify10 Spanish-American11 Spanish (Spain)

See Note 4

HSQ 2e3535 902 1352

20 5 13545 904 1352

10 3 1

3555 907 1353

2939606

10

341735

4543510

9482180

4690

:6524

2541114

FQ B-4719 7681s4 580

4 5

FQ 0-5862 1218 See Note 5

17 672 22

18 294 124 5

HSQ 2CSee Note 6

0 20 00 05 11980 14

801 225a o14 1611 16

18 850 00 0

TAPE 6506 3J-


113-115

116-117

110

119

, -@

j~l

122

In what state or foreign countrywas head of family born?001-113 State/country code088 Blank but applicableBlank

FQ B-6

See Note 7893 1320

10 28-1 5

35093610

What is the highest grade or year ofregular school head of family hasever attended?00 Never attend-ed or kindergarten only01-08 Elementary grade09-12 High school grade13-16 Col 1 ege17 Graduate school88 Blank but applicableElank

FO B-7

13814061323

515887510

4“17350 482256 630236 175

41 2316 20

4 5

FQ B-8Did head of family finish thatgrade/year?1 Yes2 No8 Elank but applicableElank

2733603

71148

780 loa390 21621 32

8 22

FQ B-9Is the head of family now married,widowed, divorced, separated or hashe or she never been married?1 Marr?ed - spouse in household2 Married - spouse not in household3 Widowed4 Divorced5 Separated6 Ne~/er married8 Elank but applicableE 1ank

27.1156

179198143189

3910

69a7

4194l-l46

74

7104870

756178183

35

FQ B-11Did head of family ever serve in theArmed Forces of the United States?1 ‘ies~ No8 E13rik but applicableElank

7802730

3510

38 239854 1096

11 134 5

FQ B-12During the past 2 weeks, did head offamily work at any time at a job orbusiness, not countinq work around thehouse?1 {es2 t+~

8 Elank but applicableBlank

2529986

3010

661 699230 638

12 114 5

Even though head of famduring those 2 weeks, da job or business?1 ‘{es2 No8 Blank but applicableBlank

ly did not workd he or she have

F(I B-13

52934

302539

l-l 15216 623

12 11665 704

TAPE 6506 32


123

124

125-127

128-130

131

Was head of family looking for work or FQ B-14on layoff from a job?1 Yes2 No8 Blank but applicableBlank

220766

302539

46 54184 583

12 12665 704

FQ B-15Which, looking for work or on layofffrom a job or both?1 Looking2 Layoff3 Both8 Blank but applicableBlank

31 32115634032

3305

9 103 9

15 15849 1287

What kind of business or industry doeshead of family work for?010-932 Industry code990 Blank but applicableB 1ank

FQ B-19See Note 9

2769 705 75249 15 22

737 187 579

FQ 6-20See Note 9

What kind of work was head of familydoing?003-889 Occupation code999 Blank but applicableBlank

277147

737

705 75024

57915

187

Class of worker1 Employee of a private company,

business or individual for wages,salary, or commission

2 A Federal government employee3 A State government employee4 A Local government employee5 Self-employed in own incorporated

business or professional practice6 Self-employed in own unincorporated

business, professional practice,or farm

7 Working without pay in familybusiness or farm

8 Blank but applicableO Never worked or never worked at a

full-time civilian job lasting2 weeks or more

Blank

FQ B-225672155 543

98118180

26

3111919

24299010

201 108 32

0 0 0

391

170

211

737 187 579

./-”-

TAPE 6506 33


SECTION G. FAMILY COMPOSITION AND INCOME DATA (POS 132-162)Source: Family Questionnaire (FCJ)

132-133 Number of persons in family (computed)01-18 Persons

134-135 Number of sample persons in family(comPuted)01-13 Persons

136 Was the total combined family incomeduring the past 12 months more or lessthan s.20,000? Include money from jobs,Social Security, retirement income, un-employment payments, public assistance,and so forth. Also include income netfrom interest, dividends, income frombusiness, farm or rent, and any othermoney income received.1 S20,000 or more2 Less than $20.0007 Refused information8 Blank but applicableBlank

137-13.9 Of those income groups, which bestrepresents the total combined familyIncome during the past 12 months?Include wages, salaries, and other itemswe just talked about. (in dollars)01 Less than 1.000

02 1,000 - i ,99903 2,000 - 2, 99904 3,000 - 3, 99905 4,000 - 4, 99906 5.000 - 5.99907 6,000 - 6,99908 7,000 - 7,99909 8,000 - 8,99910 9.000 - 9.99911 10,000 - 10.99912 11,000 - 11,99913 12.000 - 12,99914 13,000 - 13,99915 14,000 - 14,999

16 15,000 - 15,999

17 16,000 - 16,999

18 17,000 - 17,99919 18,000 - 18.99920 19,000 - 19.99921 20,000 - 24.99922 25.000 - 29,999

23 30,000 - 34,99924 35,000 - 39,99925 40,000 - 44,99926 45,000 - 49,99927 50,000 and over77 Refused information88 Blank but applicableBlank

3555 907 1353

3555 907 1353

FQ E-10

1195 361 3262233 526 1000

1.9 1 599 15 1710 4 5

2246518297

117143146118126132109143

90111

9995

104147116336293163

145107

525441

26010

76

142021322631263346313921172322

212034

1016144

4a322734

957

4

F(2 E-n

4153455

126758268455659335329324131

324546796851

312221312559

5

TAPE 6506 34


139-143

144-146

147

148-149

150

151-152

153-154

155-157

158

Per capita income (computed)00083-50000 Dollars88888 Blank but applicableB 1ank

See Note 113244 837 1264

301 66 8410 4’ 5

Poverty index (computed)Decimal not shown on tape0.04-9.78999 Blank but applicableB 1ank

see Note 12

3244 837 1264301 66 84

10 4 5

Did any member of this family receiveany Government food stamps in any ofthe paSt 12 months?1 Yes2 No8 Blank but applicableBlank

FQ E-12

619 149 5062921 752 840

5 2 210 4 5

In how many months of the past 12 monthsdid any member of this family receive foodstamps?01-12 Months88 Blank but applicable

FQ E-13

613ii

2931

1492

756

5044

845Blank

Did this family receivefood stamps last month?

any government FQ E-14

1 Yes2 No8 Blank but applicableBlank

502116

62931

120

29

2756

48125

2845

In which month did any member of thisfamily ~ receive food stamps?01-12 Month88 Blank but applicable

FQ E-15

1148

3433

292

876

252

1326Blank

For how many personsstamps authorized?01-13 Persons88 Blank but app’Blank

FQ E-16were

icab’

those food

e614 149 505

10 2 32931 756 845

FQ E-17What was the total face value of thosefood stamps received by this family inthat month?010-520 Dollars888 Blank but applicableB 1ank

585 147 49939 4 9

2931 756 845

F(2 E-18Did this family spend more for foodin that month than the value of yourfood stamps?1 Yes2 No8 Blank but applicableB1 ank

539 128 49274 21 1411 2 2

2931 756 845

TAPE 6506


159-161 How much more?003-880 Dollars888 Blank but applicableBlank

162 Is your family receivat the present time?1 Yes2 No8 Blank but appl icabBlank

ng food stamps

e

50149

3005

4743061

1010

FQ E-19120 482

10 12777 859

FQ E-20

116 473783 863

4 64 5

TAPE 6506 36

Position Item description counts 50urceand code M c P and notes

SECTION H. RESIDENCE AND HOUSEHOLD DATA (POS 163-183)Source : Family Questionnaire (FC))

Household Screener Questlonnalre (HSQ)

See Note 131009

00

15532984613

0

Size of place1 1 mllllon or more2 500,000 - 999,9993 250.000 - 499,9994 100,000 - 249,9995 50,000 - 99,9996 25,000 - 49,9997 10,000 - 24,999.9 200 - 9,9999 Not in a place

163

164

165-166

167-168

169-170

171

172-173

484423450

9156a386352491310

00

33-1235

49131

765230

Standard Metropolitan Statistical Area1 In SMSA, in central city 17712 In SMSA. not in central city 13324 Not in SMSA 452

See Note 131173

1800

334573

0

Number of persons in household01-10 Persons 3555

HSQ la1353907

Number of sample persons in household(computed)01-13 Persons 3555 907 1353

How many rooms are in this home? Countthe kitchen, but not the bathroom.01-14 Rooms00 Blank but applicableBlank

FQ E-1

35414

10

902 13461 24 5

FO E-2Do you have access to complete kitchenfacilities in this home; that is, a kitchensink with piped water, a refrigerator anda range or cookstove?1 Yes2 Noa Blank but a~pllcable

339740

10810

8.797

174

12138

1275Blank

FQ E-3

See Note 145

940362

15000G12

175

What is the mainthis home?00 No fuel used01 01102 Natural gas03 Electricity

fuel used for heating

2142

2888277

857

45006

2110

1640

45682

22300054

04 Bottled gas (propane)05 Kerosene06 Wood07 Coal08 Other, not spec!fied09 Other, specified88 Blank but applicableEl ank

TAPE 6506 37

Posit Ion Item description Counts Sourceand code M c P and notes

174-175 What is the main heating equipment forthis home?00 No heating equ~pment used01 Steam or bat water with rad~ators

or connectors

02 Central warm a~r furnace with ductsto individual rooms, or centralheat pump

03 Built-In electric units (permanentlyinstalled In wall, ceil lng, orbaseboard)

04 Floor, wall or pipeless furnace05 Room heaters with flue or vent,

burning oil . gas, or kerosene

06 Room heaters without flue or vent,burning oil , gas, or kerosene

07 Heating stove burning wood, coalor coke

08 Fireplace(s)

09 Portable electric heater(s)10 Other, not speclfled11 Other, specified88 Blank but applicable99 Oon’t knowBlank

176-177 Are any other types of equipment used forheating this home?00 No other heating equipment used01 Steam or hot water with rad~ators

or connectors02 Central warm air furnace with ducts

to Individual rooms, or centralheat pump

03 Built-In electric units (permanentlyinstalled in wall, cell lng, orbaseboard)

04 Floor. wall or plpeless furnace05 Room heaters with flue or vent,

burning oil , gas, or kerosene06 Room heaters without flue or Vent.

burning oil , gas, or kerosene07 Heating stove burning wood. coal

or coke08 Fireplace(s)09 Portable electric heater(s)10 Other, not specified11 Other , specified88 Blank but applicableBlank

178-179 What is the main fuel used by this additionalequipment?00 No fuel used01 01102 Natural gas03 Electricity04 Bottled gas (propane)05 Kerosene06 Wood07 Coal08 Other, not specified09 Other, specified88 Blank but applicableEl ank

21419

1296

219

783403

406

37

3768

053

19

10

28770

5

16

512

15

42

23995

41015

224

10

51116

62

250205

213101

1644

340

219

3012

4

0

4

950

26504

7070

9

0

00

i

o

514

i11

i6a

o01

240050002

875

FQ E--lSee Note 14

6686

96

32

12301

189

2

0207875

FQ E-5See Note 14

11323

5

1

00

16

5

4166

019

11

FQ E-6See Note 14

19

10162

114

60007

1143

TAPE 6506


180-181 What is the main fuel used for cooking in F(2 E-7this home?00 No fuel used 10 4 201 Oil02 Natural gas03 Electricity04 Bottled gas05 Kerosene

06 Wood07 Coal

5 0 92789 163 1236

639 726 78(propane) B5 7 7

0 0 30 0 00 0 0

08 Other. not speclfled o 0 009 Other, specified 8 1 08a Blank but applicable 9 2 13Blank 10 4 5

182 Do you have air-conditioning - either FQ E-8individual room units, a central systemor evaporative cool ing?1 Yes2 No8 Blank but applicableB1 ank

17331806

610

829 34773 995

1 64 5

183 Which do you have?1 Individual room unit2 Central air-conditioning3 Evaporative cooling8 Blank but applicableBlank

779603

3498

1816

FQ E-9411 328410 10

3 4G 11

77 1000

TAPE 6506

Pasltlan Item description Counts Sourceand cocie M c P and notes

SECTION 1. SAMPLE WEIGHTS (POS 184-217)

i84-ia9

190-195

196-201

202-207

2oa-213

2

2

4-215

6-217

Examined final weight000439-002711000248-000891000177-002000

3555907

1353

Interview final weight000447-002096 3555ooo207-ooo57a 907000175-001220 1353

GTT/ULTRASOUNO, AUOIOMETRY/VISION, PESTICIDE WEIGHTSBy design, only some of the persons in the sample were included in the

GTT/ultrasound. audiometry/vlslon , and pesticide components of the surveyTape positions for those persons not part of these subsamples are BLANK.

GTT/ultrasound weight000843-005302000469-001685000349-003110Blank

Audiometry/vision weightooo870-oo62a3000454-001600000343-003123B 1 ank

Pesticide weight000872-005584000454-001600000343-003117Blank

Strata code01-08

Pseudo PSU code01-02

1777

1778

1778

1777

177a

1777

3555

449

667458 6a6

45a

449

458

449

907

686667

686667

1353

3555 907 1353

TAPE G5GG 40

Position Item description counts Sourceand code M c P and notes

SECTION d. FAMILY RELATIONSHIPS (POS 218-400)Source : Adult Sample Person QUeStlOnnalre

Family CNestlonnaire

218-400 B1 ankData not yet ava lable

TAPE 6506


SECTION K. ADULT HISTORY DATA (DIABETES) (POS 401-448)

401-404

405

406

407

408-409

410-411

412

413-414

415

416-417

Source: Adult Sample PersOn QuestiOnnalre (A5pQ)

B 1ank

Positions 405-448 contain selected interview data foradults 20-74 years. These data are also found on HHANESdata tape number 6521 (Adolescent and Adult HistoryQuestionnaire) .

Do you have diabetes or sugar diabetes? ASPQ C-1i Yes 233 40 104

2 No8 Elank butB 1ank

3321 867 1248appl icable 1 0 0

0 0 1

Did a doctor1 Yes2 No8 Blank butBlank

tell you that you have it? ASPQ C-2230 39 102

3 1 1

appl icable

Did any other health professional, such asa nurse or physician’s assistant, tell youthat you have it?1 Yes2 Noa Blank but applicableB 1ank

How long ago did the (doctor/healthprofessional) first tell you that youhad diabetes?00 Less than 1 year ago01-36 Years88 Blank but applicableBlank

How old were you then?07-73 Years of age88 Blank but applicableBlank

Have you ever been told by a doctor orother health professional that youhave borderline diabetes?i Yes2 No

8 Blank but applicableBlank

How old were you then?11-69 Years

~B Blank but applicableBlank

Have you ever been told by a doctor orother health professional that you havepotential diabetes?1 Yes2 NoB Blank butBlank

How old were13-71 Years88 BlankBlank

applicable

you then?of agebut applicable

1 0 13321 867 1249

ASPQ C-3

o 0 03 1 11 0 1

3551 906 1351

ASPQ C-4See Note 15

20 7 9210 32 92

1 0 23324 868 1250

ASPQ C-5230 39 101 See Note 15

1 0 23324 868 1250

1093438

80

9027

343a

533493

90

4616

3493

11892

40

87

892

11894

20

76

894

ASPQ C-G

251319

a1

ASPQ C-724 See Note 15

91320

ASPQ C-6

171325

101

ASPQ C-7

14 See Note 1513

1326

TAPE 6506 42


418

419-420

421

422

423

424

425

426

427-429

Have you ever been told by a doctor orother health professional that you haveprediabetes?1 Yes 202 No 35268 Blank but applicable 9Blank o

How old were you then?15-71 ‘tears of age 1788 Blank but applicable 12Blank

B 1ank

When you were first toprofessional) that youwere any of the follow422-424]

The oral glucose toleryou drink a sweet drin

3526

d by a (doctor/healthhad (diabetes/...),ng tests done? (Pos.

ante test, in whichk and samples of your

blood are taken from vour arm for a few hoursafterwards?1 Yes2 No8 Blank but applicable9 Don’t knowBlank

A test for sugar or glucose in your urine?1 Yes2 No

.9 Blank but a~~l icable9 Don’t know ‘B 1 ank

A test for sugar or g1 Yes2 No8 Blank but appl icab9 Don’t knowBlank

ucose in your b

e

ood?

Were you a patient in a hospital at thetime a (doctor/health professional) firsttold you that you had (diabetes/..,)?1 Yes2 No8 Blank but applicableBlank

(Not counting that first time) Have youever been hospitalized because of yourdiabetes/. . .)?1 Yes2 NoB Blank but applicableEl ank

About how much did you weigh when youwere first told you had (diabetes/...)?028-350 Pounds888 Blank but applicableB 1ank

172130

215

3236

28423

39

3236

287la

311

3236

75241

33236

47270

23236

29722

3236

14890

30

116

890

4216

20

847

51810

047

55320

847

1345

2847

751

2847

546

847

101332

101

812

1333

7136

67

1233

10111

62

1233

105663

1233

3579

61233

1995

61233

10317

1233

ASPQ C-6

ASPQ C-7See Note 15

ASPQ C-9

ASPQ C-10

ASPQ C-11

ASPQ C-12

TAPE 65C6 43


430

431

432

433-435

436-437

438

439

440

441

Have you ever taken insulin injections?1 Yes2 No8 Blank but applicableBlank

Have you been taking insulin injectionsfor most of the past 12 months?1 Yes2 No8 Blank but applicableE 1 ank

Are you now taking insulin injections?1 Yes2 No8 Blank but applicableBlank

About how many units per day do you take?010-120 Units per day888 Blank but applicableBlank

HohI many years (have you been taking/didyou take) insulin injections?00 Less than 1 year01-36 Years88 Elank but applicableBlank

Have you ever taken diabetes pills?1 Yes2 No0 Elank but applicableBlank

Have you been taking them most of the past12 months?1 ‘fe52 No8 Elank but applicableEl ank

Are you now taking diabetes pills?1 ‘{es

Q No

8 Elank but applicableBlank

What is the name of the medicine you aretaking?i Dlabinese2 Dymelor3 Orlnase (Tolbutamide)J, ToT lnase5 Mel litron6 Diabeta/Micronase7 Other specified, non-diabetes medication8 Blank but applicableBlank

89229

13236

6227

13465

5633

13465

561

349B

2762

13465

183135

13236

9390

13371

8895

13371

572

10811

28

3466

1444

2847

682

891

592

891

43

900

952

a9i

2830

2847

1612

2877

1810

2877

140110004

887

3582

31233

2510

31315

27a3

1315

273

1323

925

41315

6552

31233

3134

31285

2936

312B5

191220116

1321

ASPQ C-13

ASPQ C-1-l

ASPQ C-15

ASPQ C-16

ASPQ C-17See Note 15

ASPQ C-18

ASPO C-19

ASPQ C-20

ASPQ C-21See Note 16

TAPE 6506 44


442-443

444

445

446

447

448

449

How many years (have you been taking/didyou take) diabetes pills?00 Less than 1 year01-26 years88 Blank but applicableB 1ank

Has a doctor, nurse, or other healthprofessional ever given you a diet orinstructions on what foods to eat for your(diabetes/... )?1 Yes2 Noa Blank but applicableB 1 ank

Do you now follow the diet or instructions?1 Yes2 No8 Blank but applicable61 ank

Do you carry or wear anything whichidentifies you as having (diabetes/...)?i Yes2 No8 Blank but applicable

Blank

When did you last see or talk to a doctoror other health professional about your(diabetes/. ..)?i During the past 2 weeks2 Over 2 weeks through 6 months3 Over 6 months through 12 months4 Over 12 months through 2 years5 Over 2 years through 5 years6 Over 5 years ago8 Blank but applicableBlank

About how many times a year do you see adoctor or other health professional aboutyour (diabetes/..,)?1 Less than once a year2 Once3 Twice4 3-4 times5 5 or more times

6 No regular schedulea Blank but applicableBlank

B 1 ank

5~129

33372

25463

23236

123131

23299

720

3877

4612

2847

2521

2859

AS?O C-22See Note 15

1747

-11205

ASPQ C-23

0826

61233

ASPQ C-244840

61259

ASPQ C-25

38 4 23279 54 90

2 2 73236 847 1233

ASPQ C-26

49 7136 25

30 640 429 1131 5

4 23236 847

4 115 122 332 661 1467 1118 4

3336 867

383913

513

57

1233

ASPQ C-27

473

17391710

1256

TAPE 6506 45


SECTION L. GLUCOSE CHALLENGE QUESTIONNAIRE (POS 450-499)

450-453 Tape Number6506

454 Assigned to fasting subsample, designatedto take oral glucose tolerance test?(see p. 10)1 Yes2 No

455 Complete oral glucosetolerance test(3 plasma glucose values)1 Complete2 Not complete3 Not in fasting subsample

456-457 Reason for incomplete oral glucosetolerance test0102030405060708091011121314151617181920

Not in fasting subsampleExamined in afternoon or eveningDiabetic currently taking insulinArrived lateIllTechnical errorFasted fewer than 10 hoursFasted more than 16 hoursRefused interviewRefused GlucolaRefused venlpunctureVenlpuncture unsuccessfulBecame ill during testGlucose in urine/glucosuria 2+Abnormal EKGRefused test because of known diabetesLeft early/ran out of timePlasma specimens thawedSpecimen not collected

Blank

458 Returned for second vis’1 Yes2 NoBlank

459-460 Reason for second visit(reason that test was not completed onfirst visit)01 Not in fasting subsample02 Examined In afternoon or evening

03 Diabetic currently taking insulin04 Arrived late05 Ill06 Technical error07 Fasted fewer than 10 hours0s Fasted more than 16 hours09 Refused interview10 Refused Glucola11 Refused venipuncture12 Venipuncture unsuccessful13 Became ill during test14 Glucose in urine/glucosuria 2+15 Abnormal EKG16 Refused test because of known diabetes17 Left early/ran out of time18 Plasma specimens thawed

19 Specimen not collected20 OtherBlank

3555

17771778

1012765

1778

1778508

1511

1189721

01110

91012

94

11657

1012

2117561778

010000

17300000000000

03534

907

449458

212237458

458170

1

044

293282312i52000

212

6443458

000000410001

00000000

901

1353

667686

See Note 17

272395686

See Notes 18,19

686254

9249

5960

258342043003

272

See Notes5

662686

8,19

See Notes 18,19

00000030010000000001

134s

TAPE 6506


461

462

463-466

467

468

469-472

473

474

475-478

Are you1 Yes2 NoBlank

Are youi Yes2 NoBlank

At whatmea 1 ?

currently taking insulin?

currently taking diabetes pills?

time did you finish your last

0030-2400 (hours:minutes)8888 Blank but applicableBlank

Yesterday/today of last meal?1 Yesterday2 Today8 Blank but applicableBlank

Have you had anything to eatsince your last meal?1 Yes2 No8 Blank but applicableBlank

At what time did You have anythingto eat since your last meal?(Colon not shown on tape)0030-2400 (hours:mlnutes)8888 Blank but applicable

B 1ank

Yesterday/today for last eat anythingat all?1 Yesterday2 Today8 Blank but applicableBlank

Have you had anything to drink, otherthan water, since the last time you hadanything to eat? (latest time inPositions 463-466 or 469-472)1 Yes2 Noa Blank but applicableBlank

At what time did you last have anythingat all to drink? (Colon not shown on tape)0010-2400 (hours:minutes)8a88 Blank but applicable

Blank

15 1 91254 278 40422a6 628 940

25 9 131229 269 3912301 629 949

See Note 20

12522

2301

119260

22301

2ao971

12303

2800

3275

25921

03275

296955

12303

2960

3259

27ao

629

25919

0629

4a229

1629

4ao

859

4040

949

3a816

0949

11628a

o949

1160

1237

47 1041 120 0

859 1237

83194

1629

110294

0949

See Note 20

See Note 20

83 ioa

o 2a24 1243

TAPE 6506


479

SECOND VISIT

480-483

484

485

486-489

490

491

492-495

Yesterday/today for last anything at allto drink?1 Yesterday2 Today8 Blank but applicableBlank

INFORMATION

Persons in this section failed tocomplete the first OGTT and were given theopportunity to take the OGTT a second time.

At what time did you finish your last meal?1200-2300 (hours:minutes)Blank

Yesterday/today of last meal?1 ‘{esterday2 TodayE 1ank

Have you had anything to eat sinceyour last meal?1 Yes2 NoBlank

At what time did you have anythingto eat since your last meal?(Colon not shown on tape)1S00-2245 (hours:mlnutes)B 1ank

Yesterday/today for last eat anything1 Yesterday2 TodayBlank

Have you had anything to drink otherthan water, since the last time youhad anything to eat (latest time inPositions 480-483 or 486-489)1 Yes2 NoBlank

At what time did you last have anythingto drink? (Colon not shown on tape)1700-2330 (hours:.minutes)Blank

256 67 6740 16 410 0 2

3259 824 1243

213534

210

3534

615

3534

6 5901 1348

6 50 0

901 1348

0 16 4

901 1348

See Note 19

See Note 20

See Note 20

6 0 13549 907 1352

6 0 10 0 0

3549 907 1352

6 0 015 6 5

3534 901 1348

See Note 20

6 0 03549 907 1353

TAPE 65G6 48

Position Item description Counts sourceand code M c P and notes

496 Yesterday/today for last anything to drink?12B

497-499~

Yesterday 6 0 0Today o 0 0

ank 3549 907 1353

ank

TAPE 6506 49


SECTION M. PLASMA GLUCOSE VALUES AND COMPUTED TIME INTERVALS (POS 500-600

ATTENTION: The colon is not shownon the tape. (Positions 500-515)

500-503 Time of first venipuncture (fasting

504-507

specimen)0800-1107 (hours:minutesBaa8 Blank but applBlank

Time Glucola given0805-1110 (hours:minutes

cab

508-511

8880 Blank but applicableBlank

Time of second venipuncture(one-hour specimen)0905-1205 (hours:minutes)8888 Blank but applicableBlank

e

5~2-515 Time of third venipuncture(two-hour specimen)1000-1245 (hours:mlnutes)8888 Blank but applicableBlank

516

517-519

520-522

523-525

Code indicating imputed time generatedfor the second venipuncture1 Yes2 NoBlank

See Note 20

1083 227 329171 51 75

2301 629 949

See Note 201059 216 283

195 62 1212301 629 949

See Note 20

1055199

2301

1031223

2301

810472500

Reasons for blank or missing (88S) plasmagluose values are given in Positions 456-457

Plasma glucose value (mg/dl)from first venipuncture051-40788a Blank but applicableBlank

Plasma glucose value (mg/dl)from second venipuncture037-639888 Blank but applicableBlank

Plasma glucose value (mg/dl)from third venipuncture026-707 -888 Blank but applicableBlank

215 27663 12a

629 949

0 1215 275692 1077

See Note 20

212 27466 130

629 949

See Note 211068 227 328

186 51 762301 629 949

See Note 21

1040 215 275214 63 129

2301 629 949

See Note 21

1016 212 272238 66 132

2301 629 949

TAPE 6506 50


526-529

530-533

534-537

538-541

542-545

546-549

550-553

554-557

558-561

562-565

566-569

570-600

ATTENTION: The colon is not shown onthe tape. (Positions 526-569)

Interval betwen last food or drinkand first venipuncture (smallest of threetimes in Positions 530-541).00:50-24:15 (hours:mlnutes)8880 Blank but applicableBlank

Interval between last meal and firstvenipuncture01:20-24:15 (hours:minutes)8888 Blank but applicableB1ank

Interval between last snack and firstvenipuncture00:50-17:47 (hours:m]nutes)aaaa Blank but applicableBlank

Interval between last drink and firstvenipuncture02:05-16:35 (hours:minutes)8888 Blank but applicableBlank

Interval between first venipuncture andGlucola ingestion00:00-01:25 (hours:minutes)8888 Blank but applicableBlank

Interval between Glucola ingestion andsecond venipuncture00:50-01:15 (hours:minutes)8888 Blank but applicableBlank

Interval beween second venipuncture andthird venipuncture00:40-01:26 (hours:minutes)8888 Blank but applicableBlank

Interval between first venipuncture andsecond venipuncture00:54-02:24 (hours:minutes)8888 Blank but applicableBlank

Interval between first venipuncture andthird venipuncture01:49-03:22 (hours:minutes)8888 Blank but applicableBlank

Interval between Glucola ingestionand third venipuncture01:41-02:24 (hours:minutes)8888 Blank but applicableBlank

Interval between last food or drinkand Glucola ingestion02:10-19:20 (hours:minutes)8888 Blank but applicableBlank

B1ank

1083171

2301

1083171

2301

25036

3269

24fl51

3256

1059195

2301

1055199

2301

1031223

2301

1055199

2301

1031223

2301

22751

629

22751

629

442

861

5822

827

21662

629

21563

629

21266

629

21563

629

21266

629

32975

949

32975

949

8a28

1237

7037

1246

283121949

276128949

274130949

27612B949

274130949

1031 212 274223 66 130

2301 629 949

1059 216 283195 62 121

2301 629 949

51

SECTION N. NOTES

1. Family Questionnaire Missinq

A Family Questionnaire was to be completed for each eligible family in ahousehold with sample persons. However, a few Family Questionnaires aremissing. Data records for sample persons in families with missing questionnairesare flagged with a code = 1, and all family data are blank. Data records forsample persons in families with a Family Questionnaire are flagged with acode = 2.

During the Mexican-American portion of the HHANES survey, a FamilyQuestionnaire continuation booklet containing sample person information waslost for one sample person. Therefore, the sociodemograohic data for thissample person are missing. The reference person, family composition, income,residence, and household data for this person were obtained from another personin the household.

2. Examination Status

Not all sample persons consented to come to a Mobile Examination ‘Center toparticipate in the examination phase of the survey. In certain rare instances(less than 0.1%), sample persons who came to the Mobile Examination Centersdid not participate in sufficient components of the examination to be consideredas “examined.” This data field contains code = 1 for those persons whoparticipated fully in the examination phase, and code = 2 for those who did notcome to the examination center or who did not satisfactorily complete theexamination.

3. Familv Number

In HHANES, all household members who were related by blood, marriage, oradoption were considered to be one “family.” All sample persons in the samefamily unit have the same computer-generated family unit code.

4. Head of Family

Relationship of Sample Person to Head of Family (Pos. 44-45)Each family containing sample persons has a designated “head offamily, ” and the relationship of each sample person to the head of hisor her family is coded in tape positions 44-45. The first threecategories of this variable describe the “head” of three differentkinds of families.

o Code ’01’ identifies sample persons who lived alone (i. e., “head” ofone-person families, no unrelated individuals living in thehousehold).

o Code ’02; identifies sample persons who lived only with unrelatedpersons.

o Code ’03’ identifies sample persons who were “heads” of familiescontaining at least one other person (whether or not the householdincluded additional families unrelated to the sample person).

5,2

Sociodemoc!ra~hic Data (Pos. 100-131)This data tape includes some sociodemographic data about the headof each sample person’s family (Section F). Because there can onlybe one “head” per family, the data in this section (positions 100-131)are the same for all sample persons in the same family (i. e., with thesame family number codes in positions 39-43). If the sample person isthe head of his or her family, the data in positions 100-131 are thesame as in the corresponding positions in Section E.

5. Observed Race

“Race” was observed by the interviewer for all sample persons actually seen.Rules for classification of observed race were consistent with those used inthe NHANES II and the National Health Interview Survey at that time. Thecategories were coded as follows:

White Includes Spanish origin persons unless they are definitely Black,Indian or other nonwhite.

Black Black or Negro.Other Race other than White or Black, including Japanese, Chinese,

American Indian, Korean, Eskimo,Q

6. National Oriqin or Ancestry

The value for national origin or ancestry is based on Item 2C in the HouseholdScreener Questionnaire and was reported by the household respondent for allhousehold members. In the Mexican-American portion of the survey, if “otherLatin-American or other Spanish” (code 9) or “Other” (code O) was recorded andthe specified origin was “Spanish-American” or “Spanish (Spain)”, a code of 10 or11, respectively, was assigned. In all three portions of the survey, if more thanone category was reported, the first appropriate “Hispanic” code, if any, wasassigned (codes 1, 2, 3, 8, 10, or 11 in the Mexican-American portion; codes 6 or7 in the Cuban-American portion; codes 4 or 5 in the Puerto Rican portion). Ifnone of these codes was recorded, the first category entered was coded.

7. Codes for States and Foreiqn Countries

Code State or Foreign Country

001002004005006008009010011012013015016017018019020021022023024

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMaryland

53

Codes for States and Foreiqn Countries (continued)

Code

025026o~7

028029030031032033034035036037038039040041042044045046047048049050051053054055056060093061062091095063064065062087066068069088070090067080071081096097098099100

State or Foreign Country

MassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsin ‘WyomingAmerican SamoaCanadaCanal ZoneCanton and Enderbury IslandsCentral AmericaCosta Rica

Republic

.sIands

CubaDominicanEl SalvadoEnderburyGermanyGuamGuatemalaHaitiHondurasJamaicaJapanJohnston AtollMexicoMidway IslandsNicaraguaPalestineAustriaLebanonChilePhilippines

54

Codes for States and Foreiqn Cbuntries (continued)

Code

101102103082072092083094089084085073074075

076

077

086078079104105106107108109110111112113114115116117118888

State or Foreign Country

BrazilHollandColombiaPanamaPuerto RicoSaudi ArabiaSpainTaiwanTurkeyUruguayVenezuelaRyukyu Islands, SouthernSwan IslandsTrust Territories of the Pacific Islands (includes Caroline,Mariana and Marshall Island groups)

U. S. miscellaneous Caribbean Islands (includes NavassaIslands, Quito Sueno Bank, Roncador Cay, Serrana Bank andSerranilla Bank)U. S. miscellaneous Pacific Islands (includes Kingman Reef,Howland, Baker & Jarvis Islands, and Palmyra Atoll)United StatesVirgin IslandsWake IslandAzoresPeruEnglandVietnamItalyEcuadorNorth AmericaSurinamArgentinaPortugalTrinidadEgyptSudanBritish HondurasChinaBlank but applicable

8. National oriqin recode

In the HHANES, if any household member was identified as “Hispanic” (asdefined below), all household members, regardless of origin, were eligible to beselected as sample persons. The national origin recode specifies whether asample person is considered to be “Hispanic” or “not Hispanic” for purposes ofanalysis. “Hispanic” is defined as:

Mexican-American, residing in selected counties of Texas, Colorado,New Mexico, Arizona, and California;

Cuban-American, residing in Dade County (Miami), Florida; orPuerto Rican, residing in the New York City area, including parts of

New Jersey and Connecticut.

55

The recode was assigned as follows:

A.

B.

c.

Southwest portion

1) If the original national origin or ancestry code on the HouseholdScreener Questionnaire was 1, 2, 3, 8, 10, or 11, then National oriqinrecode = 1;

2) If national origin or ancestry was 4, 5, 6, 7, 9, or O but the personspecified Mexican/ Mexicano, Chicano, or Mexican-American self-identification on the Adult Sample Person Questionnaire (questionM1O), or the person was the biological child of a household memberwith Recode equal to 1 (as determined by questions Al-Al 1 on theFamily Questionnaire), then National oriqin recode = 1;

3) In all other cases, National oriqin recode = 2.

Dade County, Florida portion

1) If the original national origin or ancestry code was 6 or 7, thenNational oriqin recode = 1;

2) In all other cases, National oriqin recode = 2;

New York City area ~ortion

1) If the original national origin or ancestry code was 4 or 5, thenNational oriqin recode = 1;

2) If national origin or ancestry was 1, 2, 3, 6, 7, 8, 9, or O but the personspecified Boricuan or Puerto Rican self-identification on the AdultSample Person Questionnaire (question M1O), or the person was thebiological child of a household member with Recode equal to 1 (asdetermined by questions Al-Al 1 on the Family Questionnaire), thenNational oriqin recode = 1;

3) In all other cases, National oriqin recode ❑ 2;

The national origin recode may be used in analysis in one of two ways:

a. Selecting on Recode = 1 will restrict analysis to “Hispanics” only. Inthis case, in the Southwest portion of the survey, the weightedestimates by age and sex will approximately equal U.S. Bureau ofCensus population estimates of the number of Mexican Americans anda small proportion of other Hispanics assumed to be Hispano in thefive Southwest States (Arizona, California, Colorado, New Mexico, andTexas) at the midpoint of the Mexican-American portion of HHANES -March 1983. The weighted estimates of Cuban Americans representsan independent estimate of the number of Cuban Americans in DadeCounty at the midpoint, February 1984. The weighted estimates ofPuerto Ricans represents an independent estimate of the number ofPuerto Ricans in the sample counties in New York, New Jersey, andConnecticut at the midpoint of the Puerto Rican portion - September1984.

b. Using Recode greater than O, that is, all sample persons, will include‘rHispanic” and “not Hispanic” persons and the Southwest weightedestimates by age and sex will overestimate the U.S. Bureau of theCensus population estimates of Mexican Americans and otherHispanics by about 4.5 percent. In Dade Countyr using Recode greaterthan O will increase the weighted estimates by about 5.3 percent overthat for Cuban Americans only, using Recode greater than O for theNew York area will increase the weighted estimates by about 9.2percent over that for Puerto Ricans only.

9, Industry and Occupation Code

Family Questionnaire questions B12 through B15 (see page 117 or 139 of Ref.No. 1 in Section C) identified sample persons 17 years old or older who were inthe labor force working for pay at a job or business or who worked without pay ina family business or farm operated by a related member of the household withoutreceiving wages or salary for work performed.

Questions B17 through B22 provided a full description of sample persons’ currentor most recent job or business. The detail asked for in these questions wasnecessary to properly and accurately code each occupation and industry,Interviewers were trained to define a job as a definite arrangement for regularwork for pay every week or every month. This included arrangements for eitherregular part-time or regular full-time work. If a sample person was absent fromhis or her regular job, worked at more than one job, was on layoff from a job orwas looking for work during the two week reference period, interviewers weretrained to use the following criteria to determine the job described:

a. If a sample person worked at more than one job during the two weekreference period or operated a farm or business and also worked forsomeone else, the job at which he or she worked the most hours wasdescribed. If the sample person worked the same number of hours atall jobs, the job at which he or she had been employed the longest wasentered. If the sample person was employed at all jobs the samelength of timer the job the sample person considered the main job wasentered.

b. If a sample person was absent from his or her regular job all of the twoweek reference period, but worked temporarily at another job, the jobat which the sample person actually worked was described, not the jobfrom which he or she was absent.

c. If a sample person had a job but did not work at all during the twoweek reference period, the job he or she held was described.

d. If a sample person was on layoff during the two week reference period,the job from which he or she was laid off, regardless of whether it wasa full-time or part-time job, was described.

e. If a sample person was looking for work or waiting to begin a new jobwithin 30 days of the interview, the last full-time civilian job whichlasted two consecutive weeks or more was described.

The, 1980 census of population Alphabetical Index of Industries and Occupationswas used in the coding of both industry and occupation. This book has Library ofCongress Number 80-18360, and is for sale by the Superintendent of Documents,U.S. Government Printing Office, Washington, D.C. 20402 for $3.00. Its StockNumber is 003024049-2.

57

10, Health Insurance

a. In the Health Insurance section of the Family Questionnaire, up to threeseparate health insurance plans could be reported for a family, Eachsample person could have been covered by any combination of thethree, or by none at all. In order to simplify the health insurancecoverage data, the information on all reported plans was combined to asingle variable for each sample person, i.e., whether or not the person iscovered by any plan (position 74). For all persons covered by at leastone plan, information on the type of coverage is then indicated; position75 specifies whether any of the sample person’s plans pays hospitalexpenses and position 76 specifies whether any of the sample person’splans pays doctors’ or surgeons’ bills.

b. For all sample persons who were not covered by Medicare or any healthinsurance plan, the reasons for not being covered were ascertained.Positions 77-78 contain the main or only reason reported. For personswith one or more additional reasons, the first (lowest) code entered onthe questionnaire was coded in positions 79-80.

11. Per CaDita Income

Per capita income was computed by dividing the total combined family incomeby the number of people in the family.

12. Poverty Index

The poverty index is a ratio of two components. The numerator is the midpointof the income bracket reported for each family in the Family Questionnaire(El 1). Respondents were asked to report total combined family income duringthe 12 months preceding the interview. The denominator is a poverty thresholdwhich varied with the number of persons in the family, the adult/childcomposition of the family, the age of the reference person, and the month andthe year in which the family was interviewed.

(Note 12 continues on next page)

Poverty thresholds published in Bureau of the Census reports* are based oncalendar years and were adjusted to reflect differences caused by inflationbetween calendar years and 12 month income reference periods to which,question El 1 referred. Average Consumer Price Indexes for all Urban consumers(CPI-U) for the calendar year for which the poverty thresholds were published(see table below) and for the 12 months representing the income reference periodfor the respondent were calculated, The percentage difference between thesetwo numbers represents the inflation between these two periods and was appliedto the poverty threshold appropriate for the family (based on the characteristicslisted above). For example, for a family interviewed in November, 1983, the1982 poverty threshold was updated to reflect inflation by multiplying by thepercent change in the average CPI-U for the 12 month reference period, whichwould have been November, 1982 through October, 1983, over the calendar yearJanuary through December, 1982, in this example. To compute poverty indexes,the midpoint of the total combined family income bracket was divided by theupdated poverty threshold,

Average Consumer Price Index, all Urban consumers (C PI-U),U. S. city average, 1981-84

Month Year

1981 1982 1983 1984

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

260.5263.2265.1266.8269.0271.3274.4276,5279.3279.9280,7281,5

282.5283.4283.1284.3287.1290.6292.2292.8293.3294.1293.6292.4

293.1293.2293.4295.5297.1298.1299.3300.3301.8302.6303.1303.5

Average 272.4 289.1 298.4

305.2306.6307.3308.8309.7310.7311.7313.0

Source: U.S. Department of Labor, Bureau of LaborStatistics .

* U.S. Bureau of the Census, Current Population Reports, Series P-60, No.138, “Characteristics of the Population Below the Poverty Level: 1981”,U.S. Government Printing Office, Washington, D. C., March 1983.

U.S. Bureau of the Census, Current Population Reports. Series P-60, No,144, “Characteristics of the Population Below the Pove-ty Level: 1982”,U.S. Government Printing Office, Washington, D. C., Mar~,h 1984.

59

Members of families with incomes equal to or greater than poverty thresholdshave poverty indexes equal to or greater than 1.0 and can be described as “at orabove poverty”; those with incomes less than the poverty threshold have indexesless than 1.0 and can be described as ““below poverty”.

Poverty thresholds used were computed on a national basis only. No attemptwas made to adjust these thresholds for regional, State, or other variations in thecost of living. None of the noncash public welfare benefits such as food stampbonuses were included in the income of the low income families receiving thesebenefits.

13. Size of Place and SMSA

Codes for size of place and SMSA were obtained from Bureau of Census summarytape files (STFIB).

A place is a concentration of population. Most places are incorporated as cities,towns, villages or boroughs, but others are defined by the Bureau of the Censusaround definite residential nuclei with dense, city-type street patterns, with,ideally, at least 1,000 persons per square mile. The boundaries of Census definedplaces may not coincide with civil divisions.

A Standard Metropolitan Statistical Area (S MSA) is a large population nucleusand nearby communities which have a high degree of economic and socialintegration with that nucleus. Generally, an SMSA includes one or more centralcities, all urbanized areas around the city or cities, and the remainder of thecounty or counties in which the urbanized areas are located. SMSAS aredesignated by the Office of Management and Budget.

The same place size and SMSA codes were assigned to all persons in the samesegment (for the definition of segments see Ref. No. 1 in Section C). In a fewcases segments were divided by place boundaries. In these cases codes wereassigned after inspecting segment maps. If the segment was predominantly inone place, then the place code for that place was used. [f the segment wasapproximately evenly divided, the code for the larger place was used.

14. Home Heatinq

Questions E3 through E6, pertaining to the main fuel and equipment used forheating the home, appear to have codes which are inconsistent. It has beenverified that these are the codes that were recorded on the original document;that is, codes that appear inconsistent were not incorrectly keyed.

15. Illoqical or extreme values

The responses for some sample persons for this variable may appear extreme,illogical, or inconsistent with responses in other variables. The data entry wasverified through direct review of the collection form or a copy of it. Theseresponses may not represent fact but they are included as they were recorded.The user must determine if these responses should be included in analyses.

60

16. Responses specified in open-ended response categories

Some of the “other” or “specify” responses to this question were recoded toexisting categories, if possible. For responses that could not be recoded, newcode categories were created if the information was deemed analytically useful.Caution should be used in interpreting the data from these new categoriesbecause there is no way of knowing which other respondents would have selectedone of the new categories if given the option.

17. Complete qlucose tolerance test

For this data item, persons for whom three plasma glucose values were availableare considered to have a complete glucose tolerance test, regardless of theconditions under which these values were obtained (such as length of fast orelapsed time between venipunctures). However, users may wish to take suchconditions into account for analyses of these data.

18. Reasons for incomplete test

Codes 01-03 were supplied in the editing process. Persons not assigned to thefasting subsample (code 01) were not designated to take the glucose tolerancetest nor to complete the Glucose Challenge Questionnaire (GCQ). Personsassigned to the fasting subsample who were unable or unwilling to be examined inthe morning (Code 02) did not complete the GCQ or receive the test, because thetest was only administered in the morning. Persons currently using insulin whowere in the fasting subsample and who were examined in the morning (Code 03)were not asked to fast and were not administered the test, per the studyprotocol. This exclusion was made because it was not considered medicallyadvisable for a person using insulin to fast.

Persons in the fasting subsample who were examined in the morning may havefailed to complete the test for reasons noted in GCQ 6A-6J, corresponding tocodes 04-13.

Codes 14-19 are recodes of notations on the questionnaire or other informationfrom survey records. Some persons were inappropriately eliminated from theglucose tolerance test by one physician examiner because of glucosuria (code 14),an abnormal EKG (code 15) or known diabetes in a person not taking insulin (code16). In addition, some persons refused the test because of known diabetes (code16).

19. Second visit

Persons who did not complete the OGTT at the initial examination were giventhe opportunity to return for a second visit to take the OGTT on a different day.If the person returned for a second visit, the reason for not completing the OGTTon the first visit is coded in positions 459-460; otherwise positions 459-460 areblank. If the persons did not return for a second visit, the reason for notcompleting the OGTT on the first visit is coded in positions 456-457.

If the person completed the OGTT on the second visit, positions 456-457 areblank; if the person returned for a second visit but did not complete the OGTT,the reason for not completing the OGTT on the second visit is coded in positions456:457. Data from the second visit on times of last food and drink are enteredin positions 480-496.

61

20. Time usinq 24-hour clock

These times are presented using the 24-hour block system (military time) inwhich 0100 corresponds to 1 a.m., 1200 corresponds to 12 noon, 1300 correspondsto 1 p.m., and 2400 corresponds to 12 midnight.

21. Plasma qlucose determinations

Glucose values were determined at the Centers for Disease Control, Division ofEnvironmental Health Laboratories. Glucose was measured by a micro-adaptation of the National Glucose Reference method (1) on a Gil ford System3500 Computer-Directed Analyzer (2). The determination is based on theenzymatic coupling of hexokinase and glucose-6-phosphate dehydrogenase (G-6-PD), and it has been optimzed for D-Glucose. See the Laboratory Procedures forthe Hispanic Health and Nutrition Examination Surve V (HHANES) 1982-1984 (3)pages 21-24 for exact details of the plasma glucose calculation.

References

1. Neese, J. W., Duncan, P., Bayse, D., Robinson, M., Cooper, T., Steward,C.: Development and evaluation of a hexokinase/g lucose-6-phosphatedehydrocjenase procedures for use as a national glucose reference method.Atlanta:- Centers for Disease Control, 1976.(CDC) 77-8330.

2. Gilford Laboratories, Inc. Instruction manualComputer-directed Analyzer. Oberlin, Ohio:June 1978.

DHE-W Publication No.

for the Gilford System 3500Gilford Laboratories, Inc.

3. Gunter, E.W. and Miller, D. T.: Laboratory procedures used by theDivision of Environmental Health, Laboratory Sciences Center forEnvironmental Health, Centers for Disease Control for the HispanicHealth and Nutrition Examination Survey (HHANES) 1982-84. Atlanta:Centers for Disease Control, 1986.

*.5. GOVERNMENT PRINTING OFFICE, 1992-312 -07 L!-60029

NCHS 0043