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Scientific Data Documentation
Anthropometry (1982-1984)DSN: CC37.HSPHANES.ANTHRO CC37.HSPHANES.ANTHRO2 ABSTRACT General Information Hispanic Health and Nutrition Examination Survey Mexican Americans Cuban Americans Puerto Ricans The Hispanic Health and Nutrition Examination Survey (HHANES) was conducted from July 1982 through December 1984. The data on the tape documented here are from all three portions of the survey: Mexican Americans Residing in selected counties of Texas, Colorado, New Mexico, Arizona, and California Surveyed from July 1982 through November 1983 9,894 persons sampled; 8,554 interviewed; 7,462 examined Cuban Americans Residing in Dade County (Miami), Florida Surveyed from January 1984 through April 1984 2,244 persons sampled; 1,766 interviewed; 1,357 examined Puerto Ricans Residing in New York City area, including parts of New Jersey and Connecticut Surveyed from May 1984 through December 1984 3,786 persons sampled; 3,369 interviewed; 2,834 examined Important Caution Notice C A U T I O N BEFORE USING THIS DATA TAPE, PLEASE READ THIS PAGE. o Read the accompanying description of the survey, "The Plan and Operation of the Hispanic Health and Nutrition Examination Survey", DHHS Publication No. (PHS) 85-1321 before conducting analyses of the data on this tape. o Two aspects of HHANES, especially, should be taken into account when conducting any analyses: the sample weights and the complex survey design. o Analyses should not be conducted on data combined from the three portions of the survey (Mexican-American, Cuban-American, Puerto Rican). o HHANES is a survey of Hispanic households and some of the sample persons included on this tape are not of Hispanic origin. A detailed description of the data codes dealing with national origin or ancestry appears in the NOTES section of this document. o Examine the range and frequency of values of a variable before conducting an analyses of data. The range may include unusual or unexpected values. The frequency counts may be useful to determine which 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 by a proxy. o For some data items, reference is made to a note. The notes (in a separate section of this document) may be very important in data analyses. Attention to them is strongly urged. This Public Use Data Tape has been edited very carefully. Numerous consistency and other checks were also performed. Nevertheless, due especially to the large number of data items, some errors may have gone undetected. Please bring to the attention of NCHS any errors in the data tape or the documentation. Errata sheets will be sent to people who have purchased the data tapes and corrections will be made to subsequently released data tapes. In publications, please acknowledge NCHS as the original data source. The acknowledgment should include a disclaimer crediting the authors for analyses, interpretations, and conclusions; NCHS should be cited as being responsible for only the collection and processing of the data. In addition, NCHS requests that the acronym HHANES be placed in the abstracts of journal articles and other publications based on data from this survey in order to facilitate the retrieval of such materials through automated bibliographic searches. Please send reprints of journal articles and other publications that include data from this tape to NCHS. Division of Health Examination Statistics National Center for Health Statistics Center Building, Room 2-58 3700 East-West Highway Hyattsville, MD 20782 Public Use Data Tapes for the Hispanic Health and Nutrition Examination Survey will be released through the National Technical Information Service (NTIS) as soon as the data have been edited, validated, and documented. A list of NCHS Public Use Data Tapes that can be purchased from NTIS may be obtained by writing the Scientific and Technical Information Branch, NCHS. Scientific and Technical Information Branch National Center for Health Statistics Center Building, Room 1-57 3700 East-West Highway Hyattsville, MD 20782 301-436-8500 BACKGROUND The National Center for Health Statistics (NCHS) collects, analyzes, and disseminates data on the health status of Americans. The results of surveys, analyses, and studies are made known primarily through publications and the release of computer data tapes. This document contains details required to guide programmers, statistical analysts, and research scientists in the use of a Public Use Data Tape. From 1960 through 1980 NCHS conducted five population-based, national health examination surveys. Each survey involved collecting data by direct physical examination, the taking of a medical history, and laboratory and clinical tests and measurements. Questionnaires and examination components have been designed to obtain and support analyses of data on certain targeted conditions such as diabetes, hypertension, and anemia. Beginning with the first National Health and Nutrition Examination Survey (NHANES I) a nutrition component was added to obtain information on nutritional status and dietary practices. The numbers of Hispanics in these samples were, however, insufficient to enable adequate estimation of their health conditions. From 1982 through 1984 a Hispanic Health and Nutrition Examination Survey (HHANES) was conducted to obtain 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 New York City area, including parts of New Jersey and Connecticut. The general structure of the HHANES sample design was similar to that of the previous National Health and Nutrition Examination Surveys. All of these studies have used complex, multistage, stratified, clustered samples of defined populations. The major difference between HHANES and the previous surveys is that HHANES was a survey of three special subgroups of the population in selected areas of the United States rather than a national probability sample. A detailed presentation of the design specifications is found in Chapter 5 of "Plan and Operation of the Hispanic Health and Nutrition Examination Survey, 1982-84" (Ref. No. 1). METHODS Data Collection and Processing Procedures Data collection began with a household interview. Several questionnaires were administered: o A Household Screener Questionnaire (HSQ), administered at each selected address, for determining household eligibility and for selecting sample persons. o A Family Questionnaire (FQ), administered once for each family containing sample persons, which included sections on family relationships, basic demographic information for sample persons and head of family, Medicare and health insurance coverage, participation in income assistance programs, and housing characteristics. o An Adult Sample Person Questionnaire (ASPQ), for persons 12 through 74 years which, depending on age, included sections on health status measures, health services utilization, smoking (20 through 74 years), meal program participation, and acculturation. Information on the use of medicines and vitamins in the past two weeks was also obtained. o A Child Sample Person Questionnaire (CSPQ), for sample persons 6 months through 11 years which included sections on a number of health 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 two weeks was also obtained. At the Mobile Examination Center two questionnaires were administered and an examination performed: o An Adult Sample Person Supplement (ASPS), for sample persons 12 through 74 years, which included sections on alcohol consumption, drug abuse, depression, smoking (12 through 19 years), pesticide exposure, and reproductive history. o A Dietary Questionnaire (DQ), for persons 6 months through 74 years, by which trained dietary interviewers collected information about "usual" consumption habits and dietary practices, and recorded foods consumed 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 procedures were administered to which examinees. A dentist performed a dental examination and a vision test. Technicians took blood and urine specimens and administered a glucose tolerance test, X-rays, electrocardiograms, and ultrasonographs of the gallbladder. Technicians also performed hearing tests and took a variety of body measurements. A physician performed a medical examination focusing especially on the cardiovascular, gastrointestinal, neurological, and musculoskeletal systems. The physician's impression of overall health, nutritional and weight status, and health care needs were also recorded. Some blood and urine specimen analyses were performed by technicians in the examination center; others were conducted under contract at various laboratories. Data presented in Sections E through H and the family relationships data in Section J were collected on the Household Screener and Family Questionnaires. Data presented in Section K including height, weight, skinfold, and other anthropometric measurements were collected by trained technicians using standardized procedures, highly calibrated equipment and multiple measurements. A complete description of measurement procedures and equipment is given in the Appendix. Completed interview and examination forms were reviewed in the Survey's field offices and again at the data processing center of NCHS by clerical editors. The editors checked the forms for completeness, clarity, and compliance with skip patterns, and they coded items such as industry and occupation. At the data processing center the data were keyed and verified on key-to-disk data entry equipment under the control of programs that checked for valid codes and ranges, compliance with skip patterns, and consistency. After being keyed, data were reedited by analysts for reasonableness and consistency and for compliance with instructions for sampling and questionnaire administration. The body measurement data, like the questionnaire data, have undergone numerous quality control and editing procedures in both the data collection and data processing phases of the survey. Where possible, the results have been compared with those of previous studies. When a skinfold was too tight to be measured, "tight skin" was written in the recording space for that skinfold. These cases are coded as 8's on the data tape. Also, if a skinfold was measured at over 60 mm, it was recorded as "60" (See Appendix). The examination protocol included training and periodic retraining of examiners by a supervisor and consultant, as well as an ongoing system of quality control procedures to reduce variability introduced by errors of measurement. Despite these efforts to reduce measurement errors, residual errors of a magnitude large enough to warrant concern occur in any anthropometric survey. In the HHANES, systematic examiner differences were observed for triceps, subscapular, iliac crest and medial calf skinfolds and elbow breadth. The range of differences in mean body measurement values between examiners varied from 4 millimeters for elbow breadth to 5-9 millimeters for the skinfold measurements. Preliminary analyses of the data suggest that the differences may be attributable to a drift from standardized techniques associated with the use of multiple trainers for the technician teams. The use of multiple examiners increases the variability of the distribution because of the inclusion of interexaminer errors of measurement while minimizing the effect of an individual examiner bias. Users should be aware that these technician differences do exist and are encouraged to consider this issue before analyzing the elbow breadth and skinfold measures. 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 person descriptor (e.g., Age at Interview), or a question (e.g., Is sample person covered by Medicare?). Where appropriate, data entries are presented by codes. Frequency counts are given for each code. The counts are included to help the user in planning analyses and in verifying that programs account for all data. The data source is given also (e.g., from Family Questionnaire). In some cases, a note is referenced. The notes contain explanations of the item (e.g., how Poverty Index is calculated). The questionnaire data have undergone many quality control and editing procedures. The responses of sample persons to some questions may appear extreme or illogical. Self-reported data, especially, are subject to a number of sources of variability, including recall and other reporting errors. In the data clean-up process, responses that varied considerably from expected were verified through direct review of the collection form or a copy of it. Such responses 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 if possible. For responses that could not be recoded, new code categories were created if the information was deemed analytically useful. Caution should be used in interpreting the data from these new categories because there is no way of knowing which other respondents would have selected one of the new categories if given the option. Missing data or unintelligible entries were assigned a code, usually "8", which is labeled as "blank but applicable". These codes indicate that a sample person should have a data value for a particular item but for varying reasons that value is unavailable. Copies of the questionnaires and examination forms, both in English and Spanish, can be found in the plan and operation report for HHANES (Ref. No. 1). Detailed information on interviewing and examination procedures is contained in the household interviewer's manual (Ref. No. 12), the mobile examination center interviewer's manual (Ref. No. 13), and the examination staff procedures manual (Ref. No. 14). These manuals are available upon request from: Division of Health Examination Statistics National Center for Health Statistics Center Building, Room 2-58 3700 East-West Highway Hyattsville, MD 20782 301-436-7080 Sample Weights Because the HHANES sample is not a simple random one, it is necessary to incorporate sample weights for proper analysis of the data. These sample weights are a composite of individual selection probabilities, adjustments for noncoverage and nonresponse, and poststratification adjustments. The HHANES sample weights, which are necessary for the calculation of point estimates, are located on all data tapes in positions 184-213. Because of the complex sample design and the ratio adjustments used to produce the sample weights, commonly used methods of point and variance estimation and hypothesis testing which assume simple random sampling may give misleading results. In order to provide users with the capability of estimating the complex sample variances in the HHANES data, Strata and Pseudo Primary Sampling Unit (PSU) codes have been provided on all data tapes in positions 214-217. These codes and the sample weights are necessary for the calculation of variances. Variance Estimation Computer Programs There are computer programs available designed for variance estimation for complex 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-covariance matrixes. Both routines are available within the OSIRIS IV library (Ref. No. 3). SURREGR (Ref. No. 4) and SUPERCARP (Ref. No. 5) are programs that calculate variance-covariance matrixes using a linearization approach (Ref. No. 6) (Taylor series expansion). Another program, SESUDAAN (Ref. No. 7) calculates standard errors, variances, and design effects. (Note: This version of SESUDAAN should not be used to obtain variances for totals.) SURREGR and SESUDAAN are special procedures which run data under the SAS system (Ref. No. 8). Even though the total number of examined persons in this survey is quite large, subclass analyses can lead to estimates that are unstable, particularly estimates of variances. Consequently, analysis of subclasses require that the user pay particular attention to the number of sample persons in the subclass and the number of PSU's that contain at least one sample person in the subclass. Small sample sizes, or a small number of PSU's used in the variance calculations, may produce unstable estimates of the variances. A more complete discussion of these issues and possible analytic strategies for examining various hypotheses is presented in Chapter 11 of "Plan and Operation of the Hispanic Health and Nutrition Examination Survey, 1982-84" (Ref. No. 1) and in an earlier NCHS methodology (Series 2) publication (Ref. No. 9). Average Design Effects Some users, however, may not have access to the computer programs for estimating complex sample variances or may want to do their preliminary analyses without using them. In addition, variance estimates calculated from HHANES data through use of the programs described previously are likely to be unstable 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 be due to the fact that the sample was selected from relatively few areas. Therefore, the following discussion is designed to provide an alternative approach to deal with the unavailability of software and the small number of PSU'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 a complex sample to the variance of the same statistic from a simple random sample of the same size, that is, DESIGN EFFECT (DEFF) = COMPLEX SAMPLE VARIANCE SIMPLE RANDOM SAMPLE VARIANCE is often used to show the impact of the complex sample design on variances. If the design effect is near 1, the complex sample design has little effect on the variances and the user could consider assuming simple random sampling for the analysis. Some illustrative design effects for HHANES data on this tape are given in the following tables. The design effects in the tables are the average for the age groups usually presented in NCHS Series 11 publications. If the average design effect for a subgroup was less than 1.0 (implying an improvement over simple random sampling), it was coded as 1.0. The following guidelines were used in the calculation of the average design effects: 1. Exclude all persons of non-Hispanic origin, 2. Exclude all estimates for large age ranges, such as all ages combined or 'all adults', and 3. Exclude all estimates where the proportion of the subpopulation with the specific characteristic or condition was zero percent or one hundred percent. Design effects tend to be larger when age groups are combined, just as they are when the sexes are combined, as shown in the tables. The data in the tables give the user an idea of the range in design effects for selected response variables from this data tape. If a response variable is not one shown in the tables take the range into account; it is possible that a user could have one of the higher, rather than one of the lower, design effects. VARIABLES AND THEIR CATEGORIES Sociodemographic Data - Sample Person (Pos. 1-99) Source Source: Family Questionnaire (FQ) Household Screener Questionnaire (HSQ) 1-5 Sequence Number 7462 Tape Counts Source Location Item Description and Code M C P and Notes 1-5 Sample person sequence number7462 00001-09894 Mexican Americans 7462 - - 10002-12238 Cuban Americans - 1357 - 13001-16785 Puerto Ricans - - 2834 6-12 Blank Tape Counts Source Location Item Description and Code M C P and Notes 6-12 Blank 13 Portion of Survey Tape Counts Source Location Item Description and Code M C P and Notes 13 Portion of survey 1 Mexican-American (M) 7462 - - 2 Cuban-American (C) - 1357 - 3 Puerto Rican (P) - - 2834 14 Family Questionnaire Missing Tape Counts Source Location Item Description and Code M C P and Notes 14 Family Questionnaire missing 1 Yes 21 6 10 See Note 1 2 No 7441 1351 2824 15 Version Number Tape Counts Source Location Item Description and Code M C P and Notes 15 Version number 7462 1357 2834 2 16 Examination Status Tape Counts Source Location Item Description and Code M C P and Notes 16 Examination status 1 Examined 7462 1357 2834 See Note 2 2 Not examined 0 0 0 17 Language of Interview Tape Counts Source Location Item Description and Code M C P and Notes 17 Language of interview (Pos. 1-400) FQ 1 English 4513 244 1229 2 Spanish 2929 1107 1595 Blank 20 6 10 18-21 Date of Interview Tape Counts Source Location Item Description and Code M C P and Notes Date of interview HSQ 4 18-19 01-12 Month 7462 1357 2834 20-21 82-84 Year 7462 1357 2834 22-25 Date of Examination Tape Counts Source Location Item Description and Code M C P and Notes Date of examination From survey control record 22-23 01-12 Month 7462 1357 2834 24-25 82-84 Year 7462 1357 2834 26-29 Date of Birth Tape Counts Source Location Item Description and Code M C P and Notes Date of birth HSQ 2e 26-27 01-12 Month 7462 1357 2834 88 Blank but applicable 0 0 0 28-29 08-84 Year 7462 1357 2834 88 Blank but applicable 0 0 0 30-31 Age at Interview (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 30-31 Age at interview (computed) 01-74 (See next column for units) 7462 1357 2834 32 Age at Interview Units Tape Counts Source Location Item Description and Code M C P and Notes 32 Age at interview units HSQ 2f 1 Years 7342 1349 2796 2 Months 120 8 38 33-38 Age at Examination (Computed) Tape Counts Source Location Item Description and Code M C P and Notes Age at examination (computed) Positions 33-38 are all 0 for non- examined persons. 33-34 00-75 Years 7462 1357 2834 35-36 00-11 Months 7462 1357 2834 37-38 00-30 Days 7462 1357 2834 39-43 Family Number Tape Counts Source Location Item Description and Code M C P and Notes 39-43 Family number See Note 3 00002-03529 7462 - - 04005-04922 - 1357 - 07001-08584 - - 2834 44-45 Relationship to Head of Family Tape Counts Source Location Item Description and Code M C P and Notes 44-45 What is sample person's relationship HSQ 2b to head of family? Sample person is: See Note 4 01 Head of family living alone (1 145 56 113 family with only 1 member) 02 Head of family, with no related 76 23 24 persons in household (2+ persons in household) 03 Head of family, with related 1582 369 678 persons in household 04 Wife of head (husband living at 1299 300 296 home and not in Armed Forces) 05 Wife of head (husband living at 5 0 0 home and is in Armed Forces) 06 Husband of head (wife living at 35 12 37 home and not in Armed Forces) 07 Husband of head (wife living at 0 0 0 home and is in Armed Forces) 08 Child of head or head's spouse 3769 484 1437 09 Grandchild of head or head's 217 32 115 spouse 10 Parent of head or head's spouse 57 35 33 11 Other relative (includes ex- 273 46 101 spouse, daughter-in-law, etc.) 12 Foster child 4 0 0 46 Sex Tape Counts Source Location Item Description and Code M C P and Notes 46 Sex FQ B-4 1 Male 3516 636 1237 2 Female 3946 721 1597 47 Observed Race Tape Counts Source Location Item Description and Code M C P and Notes 47 Observed race FQ B-5 1 White 7213 1300 2462 See Note 5 2 Black 76 15 152 3 Other 8 3 73 8 Blank but applicable 72 15 59 9 Not observed 72 18 78 Blank 21 6 10 48-49 National Origin or Ancestry Tape Counts Source Location Item Description and Code M C P and Notes 48-49 Sample person's national origin or HSQ 2c ancestry. See Note 6 01 Mexican/Mexicano 1641 1 1 02 Mexican-American 5202 0 0 03 Chicano 102 0 0 04 Puerto Rican 7 3 2596 05 Boricuan 0 0 36 06 Cuban 4 1069 20 07 Cuban-American 0 222 0 08 Hispano - specify 150 14 26 09 Other Latin-American or other 37 18 41 Spanish - specify 00 Other - specify 276 30 114 10 Spanish-American 22 0 0 11 Spanish (Spain) 21 0 0 50-52 State or Foreign Country Born Tape Counts Source Location Item Description and Code M C P and Notes 50-52 In what state or foreign country FQ B-6 was sample person born? See Note 7 001-118 State/country code 7403 1345 2771 888 Blank but applicable 38 6 53 Blank 21 6 10 53 National Origin Recode Tape Counts Source Location Item Description and Code M C P and Notes 53 National origin recode See Note 8 "Hispanic" = Mexican-American in Southwest, Cuban-American in Florida and Puerto Rican in New York City area. 1 "Hispanic" 7197 1291 2645 2 Not "Hispanic" 265 66 189 54-55 Highest Grade or Year of Regular School Attended Tape Counts Source Location Item Description and Code M C P and Notes 54-55 What is the highest grade or year of FQ B-7 regular school sample person has ever attended? 00 Never attended or kinder- 1476 116 446 garten only 01-08 Elementary grade 3118 556 1090 09-12 High school grade 2119 400 1011 13-16 College 581 243 225 17 Graduate school 70 30 14 88 Blank but applicable 77 6 38 Blank 21 6 10 56 Finish that Grade or Year? Tape Counts Source Location Item Description and Code M C P and Notes 56 Did sample person finish that FQ B-8 grade/year? 1 Yes 3938 853 1436 2 No 1934 368 861 8 Blank but applicable 93 14 81 Blank 1497 122 456 57 Married, Widowed, Divorced, Separated, or Never Married? Tape Counts Source Location Item Description and Code M C P and Notes 57 Is sample person now married, FQ B-9 widowed, divorced, separated, or has he or she never been married? 0 Under 14 years of age 2953 297 1000 1 Married - spouse in household 2600 632 660 2 Married - spouse not in household 70 17 54 3 Widowed 161 50 66 4 Divorced 214 92 155 5 Separated 159 21 149 6 Never married 1265 241 730 8 Blank but applicable 19 1 10 Blank 21 6 10 58 Serve in U.S. Armed Forces? Tape Counts Source Location Item Description and Code M C P and Notes 58 Did sample person ever serve in the FQ B-11 Armed Forces of the United States? 1 Yes 416 27 145 2 No 3557 952 1409 8 Blank but applicable 7 3 14 Blank 3482 375 1266 59 Work at Job or Business? Tape Counts Source Location Item Description and Code M C P and Notes 59 During the past 2 weeks, did sample FQ B-12 person work at any time at a job or business, not counting work around the house? 1 Yes 2210 622 613 2 No 1751 349 930 8 Blank but applicable 19 11 25 Blank 3482 375 1266 60 Have Job or Business? Tape Counts Source Location Item Description and Code M C P and Notes 60 Even though sample person did not FQ B-13 work during those 2 weeks, did he or she have a job or business? 1 Yes 46 13 23 2 No 1704 334 902 8 Blank but applicable 20 13 30 Blank 5692 997 1879 61 Looking for Work or on Layoff from Job? Tape Counts Source Location Item Description and Code M C P and Notes 61 Was sample person looking for work FQ B-14 or on layoff from a job? 1 Yes 217 43 60 2 No 1533 304 865 8 Blank but applicable 20 13 30 Blank 5692 997 1879 62 Which, Looking for Work or on Layoff from Job or Both? Tape Counts Source Location Item Description and Code M C P and Notes 62 Which, looking for work or on layoff FQ B-15 from a job or both? 1 Looking 146 34 44 2 Layoff 46 6 8 3 Both 23 2 7 8 Blank but applicable 22 14 31 Blank 7225 1301 2744 63-65 Kind of Business or Industry Work for? Tape Counts Source Location Item Description and Code M C P and Notes 63-65 What kind of business or industry FQ B-19 does sample person work for? See Note 9 010-932 Industry code 2429 665 681 990 Blank but applicable 49 18 37 Blank 4984 674 2116 66-68 Kind of Work Doing Tape Counts Source Location Item Description and Code M C P and Notes 66-68 What kind of work was sample FQ B-20 person doing? See Note 9 003-889 Occupation code 2432 666 681 999 Blank but applicable 46 17 37 Blank 4984 674 2116 69 Class of Worker Tape Counts Source Location Item Description and Code M C P and Notes 69 Class of worker FQ B-22 1 An employee of a private company, 1912 543 551 business or individual for wages, salary, or commission 2 A Federal government employee 74 6 21 3 A State government employee 124 19 17 4 A Local government employee 169 17 56 5 Self-employed in own incorporated 17 12 7 business or professional practice 6 Self-employed in own unincorpora- 131 67 27 ted business, professional practice, or farm 7 Working without pay in family 3 0 0 business or farm 8 Blank but applicable 46 18 38 0 Never worked or never worked at a 2 1 1 full-time civilian job lasting 2 weeks or more Blank 4984 674 2116 70 Covered by Medicare? Tape Counts Source Location Item Description and Code M C P and Notes 70 Is sample person now covered by FQ C-2 Medicare? 1 Covered 303 107 139 2 Not covered 7129 1237 2674 8 Blank but applicable 6 6 11 9 Don't know 3 1 0 Blank 21 6 10 71 Covered by Social Security Medicare Paying Hospital Bills? Tape Counts Source Location Item Description and Code M C P and Notes 71 Is sample person now covered by the FQ C-3 part of Social Security Medicare which pays for hospital bills? 1 Yes 270 100 124 2 No 18 4 5 8 Blank but applicable 15 6 20 9 Don't know 6 3 1 Blank 7153 1244 2684 72 Covered by Part of Medicare Paying Doctor's Bills? Tape Counts Source Location Item Description and Code M C P and Notes 72 Is sample person now covered by that FQ C-4 part of Medicare which pays for doctor's bills? This is the Medi- care plan for which he or she or some agency must pay a certain amount each month. 1 Yes 269 100 111 2 No 17 5 17 8 Blank but applicable 15 6 20 9 Don't know 8 2 2 Blank 7153 1244 2684 73 Type of Medicare Coverage Tape Counts Source Location Item Description and Code M C P and Notes 73 Type of Medicare coverage FQ C-5 As shown on Medicare card 1 Hospital 0 0 0 2 Medical 2 0 0 3 Card not available 3 0 2 4 Hospital and medical 5 3 0 8 Blank but applicable 15 6 20 Blank 7437 1348 2812 74 Covered by Health Insurance Plan Paying Hosp., Doc., Surgeon? Tape Counts Source Location Item Description and Code M C P and Notes HEALTH INSURANCE See Note 10 74 Is sample person covered by any FQ C-11 health insurance plan which pays any part of a hospital, doctor's, or surgeon's bill? 1 Yes 4094 818 1011 2 No 3326 526 1796 8 Blank but applicable 13 7 16 9 Don't know 8 0 1 Blank 21 6 10 75 Covered by Plan Paying Part of Hospital Expenses? Tape Counts Source Location Item Description and Code M C P and Notes 75 Is sample person covered by a plan FQ C-9 that pays any part of hospital expenses? 1 Yes 4039 806 955 2 No 6 7 9 8 Blank but applicable 54 12 55 9 Don't know 8 0 8 Blank 3355 532 1807 76 Cov. by Plan Paying Doc.'s or Surgeon's Bills for Operations? Tape Counts Source Location Item Description and Code M C P and Notes 76 Is sample person covered by a plan FQ C-10 that pays any part of a doctor's or surgeon's bills for operations? 1 Yes 4034 804 945 2 No 22 11 28 8 Blank but applicable 36 10 35 9 Don't know 15 0 19 Blank 3355 532 1807 77-78 Main Reason Why Don't Carry Health Insurance Tape Counts Source Location Item Description and Code M C P and Notes Many people do not carry health FQ C-13/15 insurance for various reasons. Which of these statements describes why sample person is not covered by any health insurance (or Medicare)? (Positions 77-80) 77-78 Main Reason 01 Care received through Medicaid 267 31 854 or Welfare 02 Unemployed, or reasons related 350 40 114 to unemployment 03 Can't obtain insurance because 24 2 15 of poor health, illness or age 04 Too expensive, can't afford 1767 280 506 health insurance 05 Dissatisfied with previous 50 3 3 isurance 06 Don't believe in insurance 31 4 8 07 Have been healthy, not much sick- 206 23 31 ness in the family, haven't needed health insurance 08 Military dependent, (CHAMPUS), 45 1 15 Veteran's benefits 09 Some other reason - not specified 2 0 7 10 Some other reason - specified 255 35 58 88 Blank but applicable 118 34 77 Blank 4347 904 1146 79-80 Second Reason Why Don't Carry Health Insurance Tape Counts Source Location Item Description and Code M C P and Notes Many people do not carry health FQ C-13/15 insurance for various reasons. Which of these statements describes why sample person is not covered by any health insurance (or Medicare)? (Positions 77-80) 79-80 Second Reason 00 No second reason reported 2573 339 1374 01 Care received through Medicaid 70 17 58 or Welfare 02 Unemployed or reasons related to 109 30 30 unemployment 03 Can't obtain insurance because of 4 2 3 poor health, illness or age 04 Too expensive, can't afford 168 20 132 health insurance 05 Dissatisfied with previous 15 1 2 insurance 06 Don't believe in insurance 18 3 3 07 Have been health, not much sick- 47 4 8 ness in the family, haven't needed health insurance 08 Military dependent, (CHAMPUS), 0 0 2 Veteran's benefits 09 Some other reason - not specified 0 0 0 10 Some other reason - specified 25 8 7 88 Blank but applicable 86 29 69 Blank 4347 904 1146 81-87 Blank Tape Counts Source Location Item Description and Code M C P and Notes 81-87 Blank 88 Received Health Care which has been/will be Paid by Medicaid? Tape Counts Source Location Item Description and Code M C P and Notes 88 During the last 12 months, has sample FQ D-6 person received health care which has been or will be paid for by Medicaid? 1 Yes 537 101 1076 2 No 6859 1242 1708 8 Blank but applicable 45 7 40 9 Don't know 0 1 0 Blank 21 6 10 89 Have Medicaid Card Tape Counts Source Location Item Description and Code M C P and Notes 89 Does sample person have a Medicaid FQ D-8 card? 1 Yes 530 104 1144 2 No 6872 1232 1647 8 Blank but applicable 39 15 33 9 Don't know 0 0 0 Blank 21 6 10 90 Status of Medicaid Card Tape Counts Source Location Item Description and Code M C P and Notes 90 Status of sample person's Medicaid FQ D-9 card? 1 Medicaid card seen - current 382 84 832 2 Medicaid card seen - expired 7 0 12 3 No card seen 128 17 274 4 Other card seen 0 0 0 5 Other card seen (specify) 5 0 2 8 Blank but applicable 47 18 57 Blank 6893 1238 1657 91 Covered by Other Public Ass. Program Paying for Health Care? Tape Counts Source Location Item Description and Code M C P and Notes 91 Is sample person now covered by any FQ D-11 other public assistance program that pays for health care? 1 Yes 54 2 28 2 No 7376 1348 2780 8 Blank but applicable 11 1 15 9 Don't know 0 0 0 Blank 21 6 10 92 Rec. Armed Forces Retirement Pay or Veteran's Admin. Pension? Tape Counts Source Location Item Description and Code M C P and Notes 92 Does sample person now receive FQ D-13 military retirement payments from any branch of the Armed Forced or a pension from the Veteran's Admini- stration? Do not include VA disa- bility compensation. 1 Yes 56 4 9 2 No 7373 1346 2806 8 Blank but applicable 12 1 9 9 Don't know 0 0 0 Blank 21 6 10 93 Armed Forces Retirement, VA Pension, or Both? Tape Counts Source Location Item Description and Code M C P and Notes 93 Which does sample person receive: FQ D-14 the Armed Forces retirement; the VA pension; or both? 1 Armed Forces 16 0 2 2 Veteran's Administration 30 0 5 3 Both 4 4 1 8 Blank but applicable 18 1 10 Blank 7394 1352 2816 94 Covered by CHAMP-VA? Tape Counts Source Location Item Description and Code M C P and Notes 94 Is sample person now covered by FQ D-16 CHAMP-VA, which is medical insurance for dependents or survivors of dis- abled veterans? 1 Yes 45 4 10 2 No 7388 1346 2806 8 Blank but applicable 8 1 6 9 Don't know 0 0 0 Blank 21 6 10 95 Prog. Prov. Health Care for Dependents/Survivors of Military? Tape Counts Source Location Item Description and Code M C P and Notes 95 Is sample person now covered by any FQ D-18 other program that provides health care for military dependents or sur- vivors of military persons? 1 Yes 41 4 8 2 No 7387 1346 2804 8 Blank but applicable 13 1 12 9 Don't know 0 0 0 Blank 21 6 10 96 Included in AFDC "Aid to Families With Dependent Children"? Tape Counts Source Location Item Description and Code M C P and Notes 96 Is sample person included in the FQ D-2 AFDC, "Aid to Families With Dependent Children", assistance payment? 1 Yes 394 39 650 2 No 7020 1304 2134 8 Blank but applicable 27 6 39 9 Don't know 0 2 1 Blank 21 6 10 97 Rec. "Supplemental Security Income" ("SSI") Gold-Col. Check? Tape Counts Source Location Item Description and Code M C P and Notes 97 Does sample person now receive the FQ D-4 "Supplemental Security Income" or "SSI" gold-colored check? 1 Yes 131 44 135 2 No 7285 1295 2659 8 Blank but applicable 25 12 30 9 Don't know 0 0 0 Blank 21 6 10 98 Have Disability Related to Service in U.S. Armed Forces? Tape Counts Source Location Item Description and Code M C P and Notes 98 Does sample person have a disability FQ D-20 related to his or her service in the Armed Forces of the United States? 1 Yes 48 2 14 2 No 346 20 108 8 Blank but applicable 29 8 37 Blank 7039 1327 2675 99 Receive Compensation for Disability from Veteran's Admin.? Tape Counts Source Location Item Description and Code M C P and Notes 99 Does sample person now receive com- FQ D-21 pensation for this disability from the Veteran's Administration? 1 Yes 31 1 9 2 No 17 1 4 8 Blank but applicable 29 8 38 Blank 7385 1347 2783 Sociodemographic Data - Head of Family (Pos. 100-131) Source Source: Family Questionnaire (FQ) Household Screener Questionnaire (HSQ) 100 Interview and Examination Status Tape Counts Source Location Item Description and Code M C P and Notes 100 Interview and examination status of See Note 4 head of family 1 Selected as sample person, 5523 1076 2098 interviewed on Adult Sample Person Questionnaire, and examined 2 Selected as sample person, 338 62 79 interviewed on Adult Sample Person Questionnaire, but not examined 3 Selected as sample person, not 218 34 23 interviewed, and not examined 4 Not selected as sample person 1362 179 624 Blank 21 6 10 101 Blank Tape Counts Source Location Item Description and Code M C P and Notes 101 Blank 102-103 Date of Birth Tape Counts Source Location Item Description and Code M C P and Notes Date of birth HSQ 2e 102-103 01-12 Month 7413 1348 2830 88 Blank but applicable 49 9 4 104-105 08-86, 89-88 Year 7440 1353 2832 88 Blank but applicable 22 4 2 106-107 Age at Interview Tape Counts Source Location Item Description and Code M C P and Notes 106-107 Age at interview 17-95 Years 7462 1357 2834 108 Blank Tape Counts Source Location Item Description and Code M C P and Notes 108 Blank 109 Sex Tape Counts Source Location Item Description and Code M C P and Notes 109 Sex FQ B-4 1 Male 5982 1069 1331 2 Female 1460 282 1493 Blank 20 6 10 110 Observed Race Tape Counts Source Location Item Description and Code M C P and Notes 110 Observed race FQ B-5 1 White 7138 1282 2511 See Note 5 2 Black 75 27 165 3 Other 6 3 58 8 Blank but applicable 106 31 59 9 Not observed 117 8 31 Blank 20 6 10 111-112 National Origin Tape Counts Source Location Item Description and Code M C P and Notes 111-112 Head of family's national origin HSQ 2c or ancestry. See Note 6 01 Mexican/Mexicano 2068 0 3 02 Mexican-American 4523 0 0 03 Chicano 97 0 0 04 Puerto Rican 19 7 2503 05 Boricuan 0 0 29 06 Cuban 6 1197 46 07 Cuban-American 0 85 2 08 Hispano - specify 147 20 37 09 Other Latin-American or other 54 17 39 Spanish - specify 00 Other - specify 513 31 175 10 Spanish-American 17 0 0 11 Spanish (Spain) 18 0 0 113-115 State or Foreign Country Born Tape Counts Source Location Item Description and Code M C P and Notes 113-115 In what state or foreign country FQ B-6 was head of family born? See Note 7 001-118 State/country code 7362 1331 2762 888 Blank but applicable 80 20 62 Blank 20 6 10 116-117 Highest Grade or Year of Regular School Attended Tape Counts Source Location Item Description and Code M C P and Notes 116-117 What is the highest grade or year FQ B-7 of regular school head of family has ever attended? 00 Never attended or kinder- 250 7 35 garten only 01-08 Elementary grade 2959 511 889 09-12 High school grade 2896 411 1445 13-16 College 1002 336 363 17 Graduate school 170 57 41 88 Blank but applicable 165 29 51 Blank 20 6 10 118 Finish that Grade or Year? Tape Counts Source Location Item Description and Code M C P and Notes 118 Did head of family finish that FQ B-8 grade/year? 1 Yes 5710 1171 2210 2 No 1316 137 492 8 Blank but applicable 166 36 87 Blank 270 13 45 119 Married, Widowed, Divorced, Separated, or Never Married? Tape Counts Source Location Item Description and Code M C P and Notes 119 Is head of family now married, FQ B-9 widowed, divorced, separated, or has he or she never been married? 0 Under 14 0 0 0 1 Married - spouse in household 5706 1059 1295 2 Married - spouse not in household 129 9 129 3 Widowed 333 48 133 4 Divorced 492 136 376 5 Separated 388 28 452 6 Never married 320 56 418 8 Blank but applicable 74 15 21 Blank 20 6 10 120 Serve in U.S. Armed Forces? Tape Counts Source Location Item Description and Code M C P and Notes 120 Did head of family ever serve in FQ B-11 the Armed Forces of the United States? 1 Yes 1478 64 383 2 No 5883 1265 2400 8 Blank but applicable 81 22 41 Blank 20 6 10 121 Work at Job or Business? Tape Counts Source Location Item Description and Code M C P and Notes 121 During the past 2 weeks, did head FQ B-12 of family work at any time at a job or business, not counting work around the house? 1 Yes 5443 1019 1283 2 No 1923 305 1504 8 Blank but applicable 76 27 37 Blank 20 6 10 122 Have Job or Business? Tape Counts Source Location Item Description and Code M C P and Notes 122 Even though head of family did not FQ B-13 work during those 2 weeks, did he or she have a job or business? 1 Yes 101 19 28 2 No 1822 286 1476 8 Blank but applicable 76 27 37 Blank 5463 1025 1293 123 Looking for Work or on Layoff from a Job? Tape Counts Source Location Item Description and Code M C P and Notes 123 Was head of family looking for work FQ B-14 or on layoff from a job? 1 Yes 510 61 118 2 No 1413 244 1384 8 Blank but applicable 76 27 39 Blank 5463 1025 1293 124 Which, Looking for Work or on Layoff from a Job? Tape Counts Source Location Item Description and Code M C P and Notes 124 Which, looking for work or on FQ B-15 layoff from a job or both? 1 Looking 270 43 69 2 Layoff 151 12 26 3 Both 85 3 17 8 Blank but applicable 80 30 45 Blank 6876 1269 2677 125-127 Kind of Business or Industry Work for? Tape Counts Source Location Item Description and Code M C P and Notes 125-127 What kind of business or industry FQ B-19 does head of family work for? See Note 9 010-932 Industry code 5980 1080 1395 990 Blank but applicable 118 28 62 Blank 1364 249 1377 128-130 Kind of Work Doing Tape Counts Source Location Item Description and Code M C P and Notes 128-130 What kind of work was head of FQ B-20 family doing? See Note 9 003-889 Occupation code 5988 1080 1391 999 Blank but applicable 110 28 66 Blank 1364 249 1377 131 Class of Worker Tape Counts Source Location Item Description and Code M C P and Notes 131 Class of worker FQ B-22 1 Employee of a private company, 4702 842 1058 business or individual for wages, salary, or commission 2 A Federal government employee 219 4 45 3 A State government employee 246 12 54 4 A Local government employee 359 22 169 5 Self-employed in own incorpora- 49 25 14 ted business or professional practice 6 Self-employed in own unincor- 420 171 56 porated business, profes- sional practice, or farm 7 Working without pay in family 0 0 0 business or farm 8 Blank but applicable 99 32 60 0 Never worked or never worked at 4 0 1 a full-ime civilian job lasting 2 weeks or more Blank 1364 249 1377 Family Composition and Income Data (Pos. 132-162) Source G. FAMILY COMPOSITION AND INCOME DATA (POS 132-162) Source: Family Questionnaire (FQ) 132-133 Number of Persons in Family (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 132-133 Number of persons in family (computed) 01-18 Persons 7462 1357 2834 134-135 Number of Sample Persons in Family (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 134-135 Number of sample persons in family (computed) 01-13 Persons 7462 1357 2834 136 Total Combined Family Income Tape Counts Source Location Item Description and Code M C P and Notes 136 Was the total combined family FQ E-10 income during the past 12 months more or less than $20,000? Include money from jobs, Social Security, retirement income, unemployment pay- ments, public assistance, and so forth. Also include income net from interest, dividends, income from business, farm or rent, and any other money income received. 1 $20,000 or more 2353 536 578 2 Less than $20,000 4856 795 2193 7 Refused information 31 1 7 8 Blank but applicable 202 19 46 Blank 20 6 10 137-138 Group Representing Total Combined Family Income Tape Counts Source Location Item Description and Code M C P and Notes 137-138 Of those income groups, which best FQ E-11 represents the total combined family income during the past 12 months? Include wages, salaries, and other items we just talked about. (in dollars) 01 Less than 1,000 40 8 7 02 1,000 - 1,999 107 10 33 03 2,000 - 2,999 143 25 68 04 3,000 - 3,999 182 28 132 05 4,000 - 4,999 184 34 250 06 5,000 - 5,999 234 45 202 07 6,000 - 6,999 312 35 213 08 7,000 - 7,999 314 46 169 09 8,000 - 8,999 284 42 106 10 9,000 - 9,999 263 52 125 11 10,000 - 10,999 282 72 139 12 11,000 - 11,999 250 47 75 13 12,000 - 12,999 296 54 100 14 13,000 - 13,999 186 32 64 15 14,000 - 14,999 254 25 66 16 15,000 - 15,999 208 36 77 17 16,000 - 16,999 209 34 51 18 17,000 - 17,999 231 37 66 19 18,000 - 18,999 333 28 82 20 19,000 - 19,999 240 55 79 21 20,000 - 24,999 694 148 152 22 25,000 - 29,999 585 83 124 23 30,000 - 34,999 358 78 92 24 35,000 - 39,999 257 64 43 25 40,000 - 44,999 192 48 36 26 45,000 - 49,999 84 43 30 27 50,000 and over 107 55 54 77 Refused information 76 10 43 88 Blank but applicable 537 77 146 Blank 20 6 10 139-143 Per Capita Income (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 139-143 Per capita income (computed) See Note 11 00083-50000 Dollars 6829 1264 2636 88888 Blank but applicable 613 87 189 Blank 20 6 9 144-146 Poverty Index (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 144-146 Poverty index (computed) See Note 12 Decimal not shown on tape 0.04-9.78 6829 1264 2636 999 Blank but applicable 613 87 189 Blank 20 6 9 147 Member of Family Receive Government Food Stamps? Tape Counts Source Location Item Description and Code M C P and Notes 147 Did any member of this family FQ E-12 receive any Government food stamps in any of the past 12 months? 1 Yes 1651 234 1344 2 No 5783 1115 1474 8 Blank but applicable 8 2 6 Blank 20 6 10 148-149 Number of Months Member of Family Received Food Stamps Tape Counts Source Location Item Description and Code M C P and Notes 148-149 In how many months of the past 12 FQ E-13 months did any member of this family receive food stamps? 01-12 Months 1631 234 1335 88 Blank but applicable 28 2 15 Blank 5803 1121 1484 150 Did Family Receive Government Food Stamps Last Month? Tape Counts Source Location Item Description and Code M C P and Notes 150 Did this family receive any FQ E-14 government food stamps last month? 1 Yes 1345 187 1290 2 No 303 47 50 8 Blank but applicable 11 2 10 Blank 5803 1121 1484 151-152 In which Month did Member Last Receive Food Stamps? Tape Counts Source Location Item Description and Code M C P and Notes 151-152 In which month did any member of FQ E-15 this family last receive food stamps? 01-12 Months 298 47 50 88 Blank but applicable 16 2 10 Blank 7148 1308 2774 153-154 Number of Persons for which Food Stamps were Authorized Tape Counts Source Location Item Description and Code M C P and Notes 153-154 For how many persons were those FQ E-16 food stamps authorized? 01-13 Persons 1641 234 1337 88 Blank but applicable 18 2 13 Blank 5803 1121 1484 155-157 Total Face Value of Food Stamps Received by Family Tape Counts Source Location Item Description and Code M C P and Notes 155-157 What was the total face value of FQ E-17 those food stamps received by this family in that month? 010-520 Dollars 1567 230 1325 888 Blank but applicable 92 6 25 Blank 5803 1121 1484 158 Did Family Spend More for Food than Value of Food Stamps? Tape Counts Source Location Item Description and Code M C P and Notes 158 Did this family spend more for food FQ E-18 in that month than the value of your food stamps? 1 Yes 1405 194 1279 2 No 231 40 64 8 Blank but applicable 23 2 7 Blank 5803 1121 1484 159-161 How Much More Spent for Food than Value of Food Stamps? Tape Counts Source Location Item Description and Code M C P and Notes 159-161 How much more? FQ E-19 003-880 Dollars 1314 182 1258 888 Blank but applicable 114 14 28 Blank 6034 1161 1548 162 Family Receiving Food Stamps at Present Time? Tape Counts Source Location Item Description and Code M C P and Notes 162 Is your family receiving food FQ E-20 stamps at the present time? 1 Yes 1273 175 1269 2 No 6153 1171 1542 8 Blank but applicable 16 5 13 Blank 20 6 10 Residence and Household Data (Pos. 163-183) Source Source: Family Questionnaire (FQ) Household Screener Questionnaire (HSQ) 163 Size of Place Tape Counts Source Location Item Description and Code M C P and Notes 163 Size of place See Note 13 1 1 million or more 1049 0 2070 2 500,000 - 999,999 844 0 0 3 250,000 - 499,999 884 467 0 4 100,000 - 249,999 203 364 368 5 50,000 - 99,999 1277 70 76 6 25,000 - 49,999 785 205 216 7 10,000 - 24,999 746 120 79 8 200 - 9,999 1003 88 24 9 Not in a place 671 43 1 164 Standard Metropolitan Statistical Area Tape Counts Source Location Item Description and Code M C P and Notes 164 Standard Metropolitan Statistical See Note 13 Area 1 In SMSA, in central city 3707 467 2465 2 In SMSA, not in central city 2854 890 369 4 Not in SMSA 901 0 0 165-166 Number of Persons in Household Tape Counts Source Location Item Description and Code M C P and Notes 165-166 Number of persons in household HSQ 1a 01-18 Persons 7462 1357 2834 167-168 Number of Sample Persons in Household (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 167-168 Number of sample persons in household (computed) 01-13 Persons 7462 1357 2834 169-170 Number of Rooms in Home Tape Counts Source Location Item Description and Code M C P and Notes 169-170 How many rooms are in this home? FQ E-1 Count the kitchen, but not the bathroom. 01-14 Rooms 7433 1350 2816 88 Blank but applicable 9 1 8 Blank 20 6 10 171 Access to Complete Kitchen Facilities in Home? Tape Counts Source Location Item Description and Code M C P and Notes 171 Do you have access to complete FQ E-2 kitchen facilities in this home; that is, a kitchen sink with piped water, a refrigerator and a range or cookstove? 1 Yes 7136 1315 2548 2 No 83 10 18 8 Blank but applicable 223 26 258 Blank 20 6 10 172-173 Main Fuel Used for Heating in Home Tape Counts Source Location Item Description and Code M C P and Notes 172-173 What is the main fuel used for FQ E-3 heating this home? See Note 14 00 No fuel used 538 231 16 01 Oil 4 0 1988 02 Natural gas 5955 78 718 03 Electricity 604 1027 37 04 Bottled gas (propane) 174 2 0 05 Kerosene 13 3 0 06 Wood 98 3 0 07 Coal 0 0 14 08 Other, not specified 0 0 2 09 Other, specified 11 0 8 88 Blank but applicable 45 7 41 Blank 20 6 10 174-175 Main Heating Equipment for Home Tape Counts Source Location Item Description and Code M C P and Notes 174-175 What is the main heating equipment FQ E-4 for this home? See Note 14 00 No heating equipment used 538 231 20 01 Steam or hot water with 44 5 1450 radiators or convectors 02 Central warm air furnace with 2677 542 180 ducts to individual rooms, or central heat pump 03 Built-in electric units (per- 474 323 63 manently installed in wall, ceiling or baseboard) 04 Floor, wall or pipeless furnace 1598 46 21 05 Room heaters with flue or vent, 805 17 596 burning oil, gas, or kerosene 06 Room heaters without flue or 847 6 425 vent, burning oil, gas, or kerosene 07 Heating stove burning wood, 88 0 9 coal or coke 08 Fireplace(s) 91 4 0 09 Portable electric heater(s) 139 137 4 10 Other, not specified 0 0 0 11 Other, specified 114 35 16 88 Blank but applicable 1 5 23 99 Don't know 26 0 17 Blank 20 6 10 176-177 Other Types of Equipment Used for Heating Home? Tape Counts Source Location Item Description and Code M C P and Notes 176-177 Are any other types of equipment FQ E-5 used for heating this home? See Note 14 00 No other heating equipment used 6057 1073 2350 01 Steam or hot water with 0 0 13 radiators or convectors 02 Central warm air furnace with 11 15 7 ducts to individual rooms, or central heat pump 03 Built-in electric units (per- 24 0 2 manently installed in wall, ceiling or baseboard) 04 Floor, wall or pipeless furnace 11 0 0 05 Room heaters with flue or vent, 22 0 3 burning oil, gas, or kerosene 06 Room heaters without flue or 22 1 29 vent, burning oil, gas, or kerosene 07 Heating stove burning wood, 70 0 8 coal or coke 08 Fireplace(s) 449 8 9 09 Portable electric heater(s) 186 18 351 10 Other, not specified 4 2 3 11 Other, specified 18 2 4 88 Blank but applicable 30 1 25 Blank 558 237 30 178-179 Main Fuel Used by Additional Equipment Tape Counts Source Location Item Description and Code M C P and Notes 178-179 What is the main fuel used by this FQ E-6 additional equipment? See Note 14 00 No fuel used 2 0 2 01 Oil 0 0 20 02 Natural gas 96 2 27 03 Electricity 214 35 345 04 Bottled gas (propane) 9 0 1 05 Kerosene 2 0 25 06 Wood 471 8 11 07 Coal 2 0 0 08 Other, not specified 0 0 0 09 Other, specified 7 0 0 88 Blank but applicable 44 2 3 Blank 6615 1310 2380 180-181 Main Fuel Used for Cooking in Home Tape Counts Source Location Item Description and Code M C P and Notes 180-181 What is the main fuel used for FQ E-7 cooking in this home? 00 No fuel used 21 4 4 01 Oil 14 0 31 02 Natural gas 5899 253 2603 03 Electricity 1295 1083 148 04 Bottled gas (propane) 182 8 12 05 Kerosene 0 0 3 06 Wood 0 0 0 07 Coal 0 0 0 08 Other, not specified 0 0 0 09 Other, specified 14 1 0 88 Blank but applicable 17 2 23 Blank 20 6 10 182 Air-Conditioning in Home? Tape Counts Source Location Item Description and Code M C P and Notes 182 Do you have air-conditioning - FQ E-8 either individual room units, a central system or evaporative cooling? 1 Yes 3583 1254 653 2 No 3845 96 2153 8 Blank but applicable 14 1 18 Blank 20 6 10 183 Kind of Air-Conditioning Tape Counts Source Location Item Description and Code M C P and Notes 183 Which do you have? FQ E-9 1 Individual room unit 1625 583 613 2 Central air-conditioning 1233 660 22 3 Evaporative cooling 719 6 10 8 Blank but applicable 20 6 26 Blank 3865 102 2163 Sample Weights (Pos. 184-217) 184-189 Examined Final Weight Tape Counts Source Location Item Description and Code M C P and Notes 184-189 Examined final weight 000439-002711 7462 - - 000223-000891 - 1357 - 000177-002000 - - 2834 190-195 Interview Final Weight Tape Counts Source Location Item Description and Code M C P and Notes 190-195 Interview final weight 000447-002096 7462 - - 000176-000604 - 1357 - 000175-001220 - - 2834 196-213 GTT/Ultrasound, Audiometry/Vision, Pesticide Weights Tape Counts Source Location Item Description and Code M C P and Notes GTT/ULTRASOUND, AUDIOMETRY/VISION, PESTICIDE WEIGHTS By design, only some of the persons in the sample were included in the GTT/ultrasound, audiometry/vision, and pesticide components of the survey. Tape positions for those persons not part of these subsamples are BLANK. 196-201 GTT/ultrasound weight 000843-005302 1777 - - 000469-001685 - 449 - 000349-003110 5685 908 2167 Blank - - 667 202-207 Audiometry/vision weight 000507-006283 4431 - - 000223-001600 - 804 - 000264-003123 - - 1759 Blank 3031 553 1075 208-213 Pesticide weight 000872-005584 2465 - - 000441-001600 - 568 - 000343-003117 - - 1012 Blank 4997 789 1822 214-215 Strata Code Tape Counts Source Location Item Description and Code M C P and Notes 214-215 Strata code 01-08 7462 1357 2834 216-217 Pseudo PSU Code Tape Counts Source Location Item Description and Code M C P and Notes 216-217 Pseudo PSU code 01-02 7462 1357 2834 Family Relationships (Pos. 218-400) Source Source: Adult Sample Person Questionnaire Family Questionnaire 218-400 Blank Tape Counts Source Location Item Description and Code M C P and Notes 218-400 Blank Data not yet available Body Measurement Data (Pos. 401-500) Source Source: Body Measurement Examination 401-404 Tape Number Tape Counts Source Location Item Description and Code M C P and Notes 401-404 Tape number 6501 7462 1357 2834 405 Body Measurement Exam Blank Tape Counts Source Location Item Description and Code M C P and Notes 405 Body measurement exam blank See Note 15 1 Yes 14 3 24 2 No 7448 1354 2810 406-408 Examiner Number Tape Counts Source Location Item Description and Code M C P and Notes 406-408 Examiner number 100-128 7448 1354 2810 Blank 14 3 24 409-411 Recorder Number Tape Counts Source Location Item Description and Code M C P and Notes 409-411 Recorder number 091-906 7448 1354 2810 Blank 14 3 24 Attention Notice for Positions 412-499 ATTENTION: For tape positions 412-499 decimal points are not shown on the tape. Ages are 6 months-74 years unless otherwise indicated. Skeletal Breadths 412-414 Biacromial Breadth Tape Counts Source Location Item Description and Code M C P and Notes 412-414 Biacromial breadth 14.1-54.7 Centimeters 7415 1350 2798 888 Blank but applicable 33 4 12 Blank 14 3 24 415-417 Biiliac Crest Breadth Tape Counts Source Location Item Description and Code M C P and Notes 415-417 Biiliac crest breadth 10.6-47.3 Centimeters 7413 1351 2796 888 Blank but applicable 35 3 14 Blank 14 3 24 418-420 Bitrochanteric Breadth Tape Counts Source Location Item Description and Code M C P and Notes 418-420 Bitrochanteric breadth 11.7-47.7 Centimeters 7412 1350 2793 888 Blank but applicable 36 4 17 Blank 14 3 24 Elbow Breadth (Left and Right Side) Tape Counts Source Location Item Description and Code M C P and Notes ATTENTION: See Section B for discussion of systematic examiner differences observed in this survey for elbow breadth. 421-423 Elbow breadth-right side 02.5-08.9 Centimeters 7402 1347 2795 888 Blank but applicable 46 7 15 Blank 14 3 24 424-426 Elbow breadth-left side 03.1-08.5 Centimeters 1475 270 534 See Note 16 888 Blank but applicable 22 1 13 Blank 5965 1086 2287 Skinfolds Attention Notice ATTENTION: See Section B for discussion of systematic examiner differences observed in this survey for the four skinfold measures. 427-429 Triceps Skinfold-Right Side Tape Counts Source Location Item Description and Code M C P and Notes 427-429 Triceps skinfold-right side 02.0-60.0 Millimeters 7415 1350 2794 888 Blank but applicable 33 4 16 Blank 14 3 24 430-432 Triceps Skinfold-Left Side Tape Counts Source Location Item Description and Code M C P and Notes 430-432 Triceps skinfold-left side See Note 16 03.0-58.0 Millimeters 1475 269 535 888 Blank but applicable 22 2 12 Blank 5965 1086 2287 433-435 Subscapular Skinfold-Right Side Tape Counts Source Location Item Description and Code M C P and Notes 433-435 Subscapular skinfold-right side 02.0-60.0 Millimeters 7413 1347 2794 888 Blank but applicable 35 7 16 Blank 14 3 24 436-438 Subscapular Skinfold-Left Side Tape Counts Source Location Item Description and Code M C P and Notes 436-438 Subscapular skinfold-left side See Note 16 02.5-60.0 Millimeters 1474 269 535 888 Blank but applicable 23 2 12 Blank 5965 1086 2287 439-441 Iliac Crest Skinfold-Right Side Tape Counts Source Location Item Description and Code M C P and Notes 439-441 Iliac crest skinfold-right side 01.5-60.0 Millimeters 7415 1350 2792 888 Blank but applicable 33 4 18 Blank 14 3 24 442-444 Iliac Crest Skinfold-Left Side Tape Counts Source Location Item Description and Code M C P and Notes 442-444 Iliac crest skinfold-left side See Note 16 02.0-60.0 Millimeters 1476 269 535 888 Blank but applicable 21 2 12 Blank 5965 1086 2287 445-447 Medial Calf Skinfold-Right Side Tape Counts Source Location Item Description and Code M C P and Notes 445-447 Medial calf skinfold-right side 01.5-60.0 Millimeters 7399 1347 2787 888 Blank but applicable 49 7 23 Blank 14 3 24 448-450 Medial Calf Skinfold-Left Side Tape Counts Source Location Item Description and Code M C P and Notes 448-450 Medial calf skinfold-left side See Note 16 02.0-60.0 Millimeters 1470 269 533 888 Blank but applicable 27 2 14 Blank 5965 1086 2287 Circumferences Medial Calf Circumference-Right Side Tape Counts Source Location Item Description and Code M C P and Notes 451-453 Medial calf circumference-right side 10.0-59.8 Centimeters 7410 1348 2794 888 Blank but applicable 38 6 16 Blank 14 3 24 454-456 Medial Calf Circumference-Left Side Tape Counts Source Location Item Description and Code M C P and Notes 454-456 Medial calf circumference-left side See Note 16 12.5-53.1 Centimeters 1473 270 534 888 Blank but applicable 24 1 13 Blank 5965 1086 2287 457-459 Chest Circumference-Erect Tape Counts Source Location Item Description and Code M C P and Notes 457-459 Chest circumference-erect (Ages 2-7 years) 32.5-88.7, 88.9-94.7 Centimeters 1253 106 417 888 Blank but applicable 79 6 24 Blank 6130 1245 2393 460-462 Chest Circumference-Supine Tape Counts Source Location Item Description and Code M C P and Notes 460-462 Chest circumference-supine (Ages 6 months-3 years) 39.4-70.53 Centimeters 784 70 238 888 Blank but applicable 28 3 15 Blank 6650 1284 2581 463-465 Head Circumference Tape Counts Source Location Item Description and Code M C P and Notes 463-465 Head circumference (Ages 6 months-7 years) 21.4-59.5 Centimeters 1592 142 517 888 Blank but applicable 87 6 28 Blank 5783 1209 2289 466-468 Mid-Upper Arm Circumference-Right Side Tape Counts Source Location Item Description and Code M C P and Notes 466-468 Mid-upper arm circumference-right side (Upper arm girth) 08.5-52.1 Centimeters 7414 1349 2795 888 Blank but applicable 34 5 15 Blank 14 3 24 469-471 Mid-Upper Arm Circumference-Left Side Tape Counts Source Location Item Description and Code M C P and Notes 469-471 Mid-upper arm circumference-left side See Note (Upper arm girth) 16 10.2-52.4 Centimeters 1474 270 534 888 Blank but applicable 23 1 13 Blank 5965 1086 2287 Heights, Lengths, and Weight 472-475 Sitting Height Tape Counts Source Location Item Description and Code M C P and Notes 472-475 Sitting height (Ages 2-74 years) 046.3-102.8 Centimeters 7048 1304 2691 8888 Blank but applicable 52 14 15 Blank 362 39 128 476-479 Standing Height-Centimeters Tape Counts Source Location Item Description and Code M C P and Notes 476-479 Standing height-centimeters (Ages 2-74 years) 078.9-192.6 Centimeters 7085 1315 2697 8888 Blank but applicable 16 3 9 Blank 361 39 128 480-482 Standing Height-Inches (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 480-482 Standing height-inches (computed) (Ages 2-74 years) 31.1-75.8 Inches 7085 1315 2697 888 Blank but applicable 16 3 9 Blank 361 39 128 483-486 Recumbent Length Tape Counts Source Location Item Description and Code M C P and Notes 483-486 Recumbent length (Ages 6 months-3 years) 047.1-110.2 Centimeters 786 71 236 8888 Blank but applicable 26 2 17 Blank 6650 1284 2581 487-489 Crown Rump Length Tape Counts Source Location Item Description and Code M C P and Notes 487-489 Crown rump length (Ages 6 months-3 years) 33.6-79.9 Centimeters 784 71 235 888 Blank but applicable 28 2 18 Blank 6650 1284 2581 490-494 Weight-Kilograms Tape Counts Source Location Item Description and Code M C P and Notes 490-494 Weight-kilograms 006.55-174.40 Kilograms 7440 1353 2802 88888 Blank but applicable 8 1 8 Blank 14 3 24 495-499 Weight-Pounds (Computed) Tape Counts Source Location Item Description and Code M C P and Notes 495-499 Weight-pounds (computed) 014.44-384.48 Pounds 7440 1353 2802 88888 Blank but applicable 8 1 8 Blank 14 3 24 Handedness 500 Is Examinee Right or Left Handed? Tape Counts Source Location Item Description and Code M C P and Notes 500 Is examinee right or left handed? 1 Right 6509 1223 2362 2 Left 493 80 289 3 Both 71 19 57 4 Not sure 277 22 89 8 Blank but applicable 98 10 13 Blank 14 3 24 GENERAL NOTES, SOCIODEMOGRAPHIC AND BODY MEASUREMENT DATA Family Questionnaire Missing A Family Questionnaire was to be completed for each eligible family in a household with sample persons. However, a few Family Questionnaires are missing. Data records for sample persons in families with missing questionnaires are flagged with a code = 1, and all family data are blank. Data records for sample persons in families with a Family Questionnaire are flagged with a code = 2. During the Mexican-American portion of the HHANES survey, a Family Questionnaire continuation booklet containing sample person information was lost for one sample person. Therefore, the sociodemographic data for this sample person are missing. The reference person, family composition, income, residence, and household data for this person were obtained from another person in the household. Examination Status Not all sample persons consented to come to a Mobile Examination Center to participate in the examination phase of the survey. In certain rare instances (less than 0.1%), sample persons who came to the Mobile Examination Centers did not participate in sufficient components of the examination to be considered as "examined." This data field contains code = 1 for those persons who participated fully in the examination phase, and code = 2 for those who did not come to the examination center or who did not satisfactorily complete the examination. Family Number In HHANES, all household members who were related by blood, marriage, or adoption were considered to be one "family." All sample persons in the same family unit have the same computer-generated family unit code. Head of Family Relationship of Sample Person to Head of Family (Pos. 44-45) Each family containing sample persons has a designated "head of family," and the relationship of each sample person to the head of his or her family is coded in tape positions 44-45. The first three categories of this variable describe the "head" of three different kinds of families. o Code '01' identifies sample persons who lived alone (i.e., "head" of one-person families, no unrelated individuals living in the household). o Code '02' identifies sample persons who lived only with unrelated persons. o Code '03' identifies sample persons who were "heads" of families containing at least one other person (whether or not the household included additional families unrelated to the sample person). Sociodemographic Data (Pos. 100-131) This data tape includes some sociodemographic data about the head of each sample person's family (Section F). Because there can only be 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 the same family number codes in positions 39-43). If the sample person is the head of his or her family, the data in positions 100-131 are the same as in the corresponding positions in Section E. 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 in the NHANES II and the National Health Interview Survey at that time. The categories 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. National Origin or Ancestry The value for national origin or ancestry is based on Item 2c in the Household Screener Questionnaire and was reported by the household respondent for all household members. In the Mexican-American portion of the survey, if "other Latin-American or other Spanish" (code 9) or "Other" (code 0) was recorded and the specified origin was "Spanish-American" or "Spanish (Spain)", a code of 10 or 11, respectively, was assigned. In all three portions of the survey, if more than one category was reported, the first appropriate "Hispanic" code, if any, was assigned (codes 1, 2, 3, 8, 10, or 11 in the Mexican-American portion; codes 6 or 7 in the Cuban-American portion; codes 4 or 5 in the Puerto Rican portion). If none of these codes was recorded, the first category entered was coded. Codes for States and Foreign Countries Code State or Foreign Country 001 Alabama 002 Alaska 004 Arizona 005 Arkansas 006 California 008 Colorado 009 Connecticut 010 Delaware 011 District of Columbia 012 Florida 013 Georgia 015 Hawaii 016 Idaho 017 Illinois 018 Indiana 019 Iowa 020 Kansas 021 Kentucky 022 Louisiana 023 Maine 024 Maryland 025 Massachusetts 026 Michigan 027 Minnesota 028 Mississippi 029 Missouri 030 Montana 031 Nebraska 032 Nevada 033 New Hampshire 034 New Jersey 035 New Mexico 036 New York 037 North Carolina 038 North Dakota 039 Ohio 040 Oklahoma 041 Oregon 042 Pennsylvania 044 Rhode Island 045 South Carolina 046 South Dakota 047 Tennessee 048 Texas 049 Utah 050 Vermont 051 Virginia 053 Washington 054 West Virginia 055 Wisconsin 056 Wyoming 060 American Samoa 093 Canada 061 Canal Zone 062 Canton and Enderbury Islands 091 Central America 095 Costa Rica 063 Cuba 064 Dominican Republic 065 El Salvador 062 Enderbury Islands 087 Germany 066 Guam 068 Guatemala 069 Haiti 088 Honduras 070 Jamaica 090 Japan 067 Johnston Atoll 080 Mexico 071 Midway Islands 081 Nicaragua 096 Palestine 097 Austria 098 Lebanon 099 Chile 100 Philippines 101 Brazil 102 Holland 103 Colombia 082 Panama 072 Puerto Rico 092 Saudi Arabia 083 Spain 094 Taiwan 089 Turkey 084 Uruguay 085 Venezuela 073 Ryukyu Islands, Southern 074 Swan Islands 075 Trust Territories of the Pacific Islands (includes Caroline, Mariana and Marshall Island groups) 076 U.S. miscellaneous Caribbean Islands (includes Navassa Islands, Quito Sueno Bank, Roncador Cay, Serrana Bank and Serranilla Bank) 077 U.S. miscellaneous Pacific Islands (includes Kingman Reef, Howland, Baker & Jarvis Islands, and Palmyra Atoll) 086 United States 078 Virgin Islands 079 Wake Island 104 Azores 105 Peru 106 England 107 Vietnam 108 Italy 109 Ecuador 110 North America 111 Surinam 112 Argentina 113 Portugal 114 Trinidad 115 Egypt 116 Sudan 117 British Honduras 118 China 888 Blank but applicable National Origin Recode General Information In the HHANES, if any household member was identified as "Hispanic" (as defined below), all household members, regardless of origin, were eligible to be selected as sample persons. The national origin recode specifies whether a sample person is considered to be "Hispanic" or "not Hispanic" for purposes of analysis. "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; or Puerto Rican, residing in the New York City area, including parts of New Jersey and Connecticut Recode Assignments Southwest Portion 1) If the original national origin or ancestry code on the Household Screener Questionnaire was 1, 2, 3, 8, 10, or 11, then National origin recode = 1; 2) If national origin or ancestry was 4, 5, 6, 7, 9, or 0 but the person specified Mexican/Mexicano, Chicano, or Mexican-American self-identification on the Adult Sample Person Questionnaire (question M10), or the person was the biological child of a household member with Recode equal to 1 (as determined by questions A-1/A-11 on the Family Questionnaire), then National origin recode = 1; 3) In all other cases, National origin recode = 2. Dade County, Florida Portion 1) If the original national origin or ancestry code was 6 or 7, then National origin recode = 1; 2) In all other cases, National origin recode = 2. New York City Area Portion 1) If the original national origin or ancestry code was 4 or 5, then National origin recode = 1. 2) If national origin or ancestry was 1, 2, 3, 6, 7, 8, 9, or 0 but the person specified Boricuan or Puerto Rican self-identification on the Adult Sample Person Questionnaire (question M10), or the person was the biological child of a household member with Recode equal to 1 (as determined by questions A-1/A-11 on the Family Questionnaire), then National origin recode = 1. 3) In all other cases, National origin recode = 2. National Origin Recode in Analysis National origin recode may be used in analysis in one of two ways: a. Selecting on Recode = 1 will restrict analysis to "Hispanics" only. In this case, in the Southwest portion of the survey, the weighted estimates by age and sex will approximately equal U.S. Bureau of Census population estimates of the number of Mexican Americans and a small proportion of other Hispanics assumed to be Hispano in the five Southwest States (Arizona, California, Colorado, New Mexico, and Texas) at the midpoint of the Mexican-American portion of HHANES - March 1983. The weighted estimates of Cuban Americans represents an independent estimate of the number of Cuban Americans in Dade County at the midpoint, February 1984. The weighted estimates of Puerto Ricans represents an independent estimate of the number of Puerto Ricans in the sample counties in New York, New Jersey, and Connecticut at the midpoint of the Puerto Rican portion - September 1984. b. Using Recode greater than 0, that is, all sample persons, will include "Hispanic" and "not Hispanic" persons and the Southwest weighted estimates by age and sex will overestimate the U.S. Bureau of the Census population estimates of Mexican Americans and other Hispanics by about 4.5 percent. In Dade County, using recode greater than 0 will increase the weighted estimates by about 5.3 percent over that for Cuban Americans only, using recode greater than 0 for the New York area will increase the weighted estimates by about 9.2 percent over that for Puerto Ricans only. Industry and Occupation Code Family Questionnaire questions B-12 through B-15 (see page 117 or 139 of Ref. No 1 in Section C) identified sample persons 17 years old or older who were in the labor force working for pay at a job or business or who worked without pay in a family business or farm operated by a related member of the household without receiving wages or salary for work performed. Questions B-17 through B-22 provided a full description of sample persons' current or most recent job or business. The detail asked for in these questions was necessary to properly and accurately code each occupation and industry. Interviewers were trained to define a job as a definite arrangement for regular work for pay every week or every month. This included arrangements for either regular or part-time or regular full-time work. If a sample person was absent from his or her regular job, worked at more than one job, was on layoff from a job or was looking for work during the two week reference period, interviewers were trained to use the following criteria to determine the job described: a. If a sample person worked at more than one job during the two week reference period or operated a farm or business and also worked for someone else, the job at which he or she worked the most hours was described. If the sample person worked the same number of hours at all jobs, the job at which he or she had been employed the longest was entered. If the sample person was employed at all jobs the same length of time, the job the sample person considered the main job was entered. b. If a sample person was absent from his or her regular job all of the two week reference period, but worked temporarily at another job, the job at which the sample person actually worked was described, not the job from which he or she was absent. c. If a sample person had a job but did not work at all during the two week 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 a full-time or part-time job, was described. e. If a sample person was looking for work or waiting to begin a new job within 30 days of the interview, the last full-time civilian job which lasted two consecutive weeks or more was described. The 1980 census of population Alphabetical Index of Industries and Occupations was used in the coding of both industry and occupation. This book has Library of Congress 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 Stock Number is 003024049-2. Health Insurance a. In the Health Insurance section of the Family Questionnaire, up to three separate health insurance plans could be reported for a family. Each sample person could have been covered by any combination of the three, or by none at all. In order to simplify the health insurance coverage data, the information on all reported plans was combined to a single variable for each sample person, i.e., whether or not the person is covered by any plan (position 74). For all persons covered by at least one plan, information on the type of coverage is then indicated: position 75 specifies whether any of the sample person's plans pays hospital expenses and position 76 specifies whether any of the sample person's plans pays doctor's or surgeon's bills. b. For all sample persons who were not covered by Medicare or any health insurance plan, the reasons for not being covered were ascertained. Positions 77-78 contain the main or only reason reported. For persons with one or more additional reasons, the first (lowest) code entered on the questionnaire was coded in positions 79-80. Per Capita Income Per capita income was computed by dividing the total combined family income by the number of people in the family. Poverty Index Description The poverty index is a ratio of two components. The numerator is the midpoint of the income bracket reported for each family in the Family Questionnaire (E-11). Respondents were asked to report total combined family income during the 12 months preceding the interview. The denominator is a poverty threshold which varied with the number of persons in the family, the adult/child composition of the family, the age of the reference person, and the month and the year in which the family was interviewed. Poverty thresholds published in Bureau of the Census reports* are based on calendar years and were adjusted to reflect differences caused by inflation between calendar years and 12 month income reference periods to which question E-11 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 period for the respondent were calculated. The percentage difference between these two numbers represents the inflation between these two periods and was applied to the poverty threshold appropriate for the family (based on the characteristics listed above). For example, for a family interviewed in November, 1983, the 1982 poverty threshold was updated to reflect inflation by multiplying by the percent change in the average CPI-U for the 12 month reference period, which would have been November, 1982 through October, 1983, over the calendar year January through December, 1982, in this example. To compute poverty indexes, the midpoint of the total combined family income bracket was divided by the updated poverty threshold. Members of families with incomes equal to or greater than poverty thresholds have poverty indexes equal to or greater than 1.0 and can be described as "at or above poverty"; those with incomes less than the poverty threshold have indexes less than 1.0 and can be described as "below poverty". Poverty thresholds used were computed on a national basis only. No attempt was made to adjust these thresholds for regional, State, or other variations in the cost of living. None of the noncash public welfare benefits such as food stamp bonuses were included in the income of the low income families receiving these benefits. Avg. Consumer Price Index, Urban Consumers, U.S., 81-84 Average Consumer Price Index, all Urban consumers (CPI-U), U. S., city average, 1981-84 Month Year 1981 1982 1983 1984 January 260.5 282.5 293.1 305.2 February 263.2 283.4 293.2 306.6 March 265.1 283.1 293.4 307.3 April 266.8 284.3 295.5 308.8 May 269.0 287.1 297.1 309.7 June 271.3 290.6 298.1 310.7 July 274.4 292.2 299.3 311.7 August 276.5 292.8 300.3 313.0 September 279.3 293.3 301.8 October 279.9 294.1 302.6 November 280.7 293.6 303.1 December 281.5 292.4 303.5 Average 272.4 289.1 298.4 Source: U. S. Department of Labor, Bureau of Labor Statistics References *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 Poverty Level: 1982", U.S. Government Printing Office, Washington, D.C., March 1984. Size of Place and SMSA Codes for size of place and SMSA were obtained from Bureau of Census summary tape files (STF1B). 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 Census around definite residential nuclei with dense, city-type street patterns, with, ideally, at least 1,000 persons per square mile. The boundaries of Census defined places may not coincide with civil divisions. A Standard Metropolitan Statistical Area (SMSA) is a large population nucleus and nearby communities which have a high degree of economic and social integration with that nucleus. Generally, an SMSA includes one or more central cities, all urbanized areas around the city or cities, and the remainder of the county or counties in which the urbanized areas are located. SMSAs are designated by the Office of Management and Budget. The same place size and SMSA codes were assigned to all persons in the same segment (for the definition of segments see Ref. No. 1 in Section C). In a few cases segments were divided by place boundaries. In these cases codes were assigned after inspecting segment maps. If the segment was predominantly in one place, then the place code for that place was used. If the segment was approximately evenly divided, the code for the larger place was used. Home Heating Questions E-3 through E-6, pertaining to the main fuel and equipment used for heating the home, appear to have codes which are inconsistent. It has been verified that these are the codes that were recorded on the original document; that is, codes that appear inconsistent were not incorrectly keyed. Body Measurement Exam Not all sample persons who came to the mobile examination center to participate in the examination phase of the survey were given a body measurement examination. Reasons for noninclusion in the examination included insufficient time for the examination, sample person in a wheelchair, and sample person having to leave. This data field contains code= '1' for those persons who did not have a body measurement examination, andcode='2' for those who were given a body measurement examination. Left Side Measurements Left side measurements of the elbow breadth, mid-upper arm circumference, triceps skinfold, subscapular skinfold, iliac crest skinfold, medial calf circumference and medial calf skinfold were systematically done on approximately 20 percent of the examined sample persons. These measures were collected for quality control purposes and are not a representative sample of the U.S. population. Therefore, none of the sample weights are applicable for analyses using these measurements. BODY MEASUREMENT DATA Avg. Design Effects, by Sex, Mexican-American Average Design Effects, by Sex, for Selected Variables Mexican-American Portion Body Measurement Mean or Tape Both (Means) Proportion Positions Sexes Male Female Biacromial Breadth x 412-414 1.8 1.6 1.4 Elbow Breadth x 421-423 2.1 1.9 2.1 Triceps Skinfold x 427-429 1.1 1.5 1.3 Subscapular Skinfold x 433-435 2.1 1.8 1.8 Medial Calf Circumference x 451-453 1.3 1.2 1.0 Mid-upper Arm Circumference x 466-468 1.1 1.3 1.0 Weight x 495-499 1.4 1.3 1.0 Source: NCHS, HHANES, 1982-84, Tape Number 6501, Version 2. Avg. Design Effects, by Sex, Cuban-American Portion Average Design Effects, by Sex, for Selected Variables Cuban-American Portion Body Measurement Mean or Tape Both (Means) Proportion Positions Sexes Male Female Biacromial Breadth x 412-414 1.0 1.0 1.0 Elbow Breadth x 421-423 1.0 1.2 1.0 Triceps Skinfold x 427-429 1.1 1.0 1.0 Subscapular Skinfold x 433-435 1.0 1.0 1.0 Medial Calf Circumference x 451-453 1.1 1.1 1.0 Mid-upper Arm Circumference x 466-468 1.0 1.1 1.0 Weight x 495-499 1.3 1.1 1.1 Source: NCHS, HHANES, 1982-84, Tape Number 6501, Version 2. Avg. Design Effects, by Sex, Puerto Rican Portion Average Design Effects, by Sex, for Selected Variables Puerto Rican Portion Body Measurement Mean or Tape Both (Means) Proportion Positions Sexes Male Female Biacromial Breadth x 412-414 1.4 1.5 1.4 Elbow Breadth x 421-423 1.9 1.8 1.8 Triceps Skinfold x 427-429 1.6 1.5 1.7 Subscapular Skinfold x 433-435 1.0 1.0 1.4 Medial Calf Circumference x 451-453 1.5 1.6 1.2 Mid-upper Arm Circumference x 466-468 1.6 1.6 1.3 Weight x 495-499 1.2 1.4 1.2 Source: NCHS, HHANES, 1982-84, Tape Number 6501, Version 2. Example for Determining Complex Sample Variance Suppose, for example, that the average (mean) weight for 195 Mexican-American males 55-64 years was 168 pounds. Suppose, also, that the simple random sample variance was 5.35. The complex sample variance is determined by multiplying the simple random sample variance by the design effect (DEFF). In the example above, the complex sample variance = simple random sample variance x DEFF = (5.35 x (1.3) = (6.95) In a similar way, the complex sample variance of a percent can be determined. Assuming simple random sampling, the variance for the percent is calculated by converting the percent to a proportion and using the standard formula for the variance of a proportion. V = pq n This variance (V) multiplied by the design effect (DEFF) provids an estimate of the variance from a complex sample of the same sample size (n). The user can then proceed with estimating confidence intervals and testing hypotheses in the usual manner. The user should recognize that this approach does not incorporate the variance-covariance matrix. In most cases, this leads to a slight overestimate of the variance because the covariance terms, which are subtracted in the variance of a ratio, in general, are positive. Thus, in a borderline case, the null hypothesis would be less likely to be rejected (Ref. No. 11). Alternative or better approaches may exist or be developed. Users who want to suggest such approaches, or who want the latest information should contact the Scientific and Technical Information Branch (address given in the beginning of this documentation). BODY MEASUREMENT EQUIPMENT AND PROCEDURES General Information Excerpted from Instruction Manual Part 15a, Examination Staff Procedures Manual for the Hispanic Health and Nutrition Examination Survey 1982-84. Hyattsville, Maryland, 1985. Body Measurement Equipment Equipment Anthropometer parts: 2 sets of four section each, 4 sliding arms, 1 metal base Body measurement table Footstool Bitrochanteric calipers Elbow calipers Skinfold calipers Steel tape Insertion tape Special height scale Polaroid Land camera with close-up photographic lens Special light attachment for camera Self-zeroing weight scale Toledo 8805 ticket printer Toledo keyboard Set of weights for calibration of weight scale (one 25-lb. weight and five 50-lb. weights) Infant measuring board Introduction to Body Measurements Most of the body measurements are taken on all examinees. Some of the measurements are only taken on various subsets of examinees. Two anthropometers are provided; one is to be used for measuring and one is to be calibrated and reserved as a spare. Each anthropometer consists of four sections of rod and two caliper arms. The rod section used for bitrochanteric breadth measurements has one arm fixed to the top end of the instrument and the other arm free to slide. Two other rod sections are used for sitting heights and will be mounted in the metal base. The remaining section can be used as a spare when required. Measuring and Recording The anthropometric measurements consist of various heights, breadths, girths, and skinfolds. Certain measurements are routinely taken on the right side. If, because of casts, amputations, or other reasons, any of these particular measurements are taken on the left side, note the reason on the body measurement page and the unusual occurrence form. All measurements, except skinfolds, should be taken to the nearest tenth of a centimeter. Skinfold measurements are taken to the nearest half of a millimeter. If the digit to the right of the last digit to be recorded appears to be exactly "five", raise the last digit to be recorded one unit if that digit is an odd number or leave it unchanged if it is an even number. This is sometimes known as the "odd up-even down rule." When the examinee's sample number ends in a "3" or a "6", all skinfold measurements and the elbow breadth, upper arm girth, and medial calf circumference are to be done on the left side as well as on the right side of the body. If any measurement cannot be taken on the left side, write the reason not done on the body measurement and unusual occurrence forms. If a skinfold is too tight to be measured, "tight skin" should be written in the recording space for that skinfold. If a skinfold is above the measurable limits of the calipers, "60+" should be written in the recording space for that skinfold. The original examiner and recorder should complete an examination once it is started. The examiner takes each measurement and says it to the recorder. The recorder repeats the number, records it in the proper space, and says the name of the next measurement. The examiner should keep the measuring instrument set until the recorder repeats the number. If the anthropometer becomes unset in any way before the measurement is read back, the measurement should be made again. On standing measurements the recorder should see that the examinee stands erect. For the standing height measurement the recorder should check the height photo to be sure of the accuracy of the technician's reading. The recorder is important because he helps insure the accurate recording of the measurement while also helping the examiner position the examinee correctly. The recorder also assists the examiner by seeing that the steel tape is horizontal with proper tension when girths are measured. The recorder, having had the same training as the examiner, should recognize an error in measurement or in reading from the wrong scale. (The anthropometer has two scales, ascending and descending.) When he does see an error he should call it to the examiner's attention and have the mistake corrected. Procedure for Measuring Examinees Eight Years Old and Over Before and After Measuring a. Before starting the measurements, record on the control record the examiner number and the time the procedure begins. Record on the body measurement form the examiner and recorder numbers, and the age and sex of the examinee. b. After finishing the measurements, record the time on the control record; and complete the date, age, sex, height, and weight sections on the Report of Findings to Physician page of the chart. Height a. Have the examinee stand erect with his back and heels against the upright bar of the height scale ("Stand up tall" or "Stand up straight") with feet together and head in the Frankfort horizontal plane ("Look straight ahead"). Grasp the examinee under the mastoid processes and stretch him gently upward. b. While maintaining the examinee's head position with one hand, bring the horizontal bar down snugly to the examinee's head. Lock the bar in place. c. Place one of the sample number labels next to the tape on the upright bar so the label can be read on the height measurement photograph. d. Photograph the height measurement being sure that the examinee's hair does not obscure the scale when you take the photograph. Ask the examinee to step aside. e. Process the film and stick the sample number label from the height scale on the photo. Do not cover up the scale or the photographed sample number. f. Read the standing height measurement from the photograph and record it on the body measurement form in four digits to the nearest millimeter (0.1 of cm) from the metric scale. If there are less than four digits, fill in the blank spaces with zeroes as appropriate. For example, 99.0 should be 099.0. When the measurement is exactly at the half-way point between two millimeter marks, round up if the preceding whole number is odd; and round down if even. Weight a. Make sure that the electronic digital scale is in the kilogram mode. If it is not, press the LB/KG key on the keyboard face. b. Make sure that the digital LED readout shows 000.00. If it does not, press the ZERO key on the keyboard scale to zero the scale. c. Have the examinee stand on the center of the weight scale platform. d. Insert the body measurement page in the slot of the scale's printer. e. Press the PRINT key on the front of the printer to record on the body measurement page the time of day, the date, and the examinee's weight to the nearest twentieth of a kilogram. f. Check to be sure that the printed weight is legible and is the same as the weight displayed on the LED. g. Record the weight in kilograms on the body measurement form in the space provided. Always record the weight in five digits, filling in the blank spaces with zeroes as needed. For example, 44.5 should be entered as 044.50. The last digit should always be a zero or a five. Biacromial Breadth a. Have the examinee stand facing away from you in the standard erect position with his feet together and his arms hanging freely at his sides. b. Place an anthropometer arm on each of the acromial processes. c. Compress the soft tissue over the acromial processes as much as possible by applying pressure on the anthropometer arms near where they touch the body (not where they are attached to the anthropometer). d. Measure the maximum breadth of the body between the acromial processes to the nearest 0.1 cm. Be sure that the anthropometer arms do not slip off the acromial processes. This is a bone-to-bone measurement taken over the examinee's gown. Biiliac Crest Breadth a. Have the examinee stand facing away from you in the standard erect position with his feet together. b. Locate the maximum lateral width of the body between the crests of the ilia. This maximum width is in the anterior superior aspect of the body. c. Place an anthropometer arm on each iliac crest. You may need to hold the ends of the anthropometer arms in a slightly declining position. d. Compress the soft tissue over the ilia as much as possible by applying pressure on the anthropometer arms near where they touch the body (not where they are attached to the anthropometer). e. Measure the maximum breadth of the body between the iliac crests to the nearest 0.1 cm. Be sure that the anthropometer arms do not slip off the bony landmarks. This is a bone-to-bone measurement taken over the examinee's gown. Bitrochanteric Breadth a. Have the examinee stand with his feet together in the standard erect position. b. Place the caliper arms on the protuberances of the greater femoral trochanters. c. Compress the soft tissue over the trochanters as much as possible by applying pressure on the caliper arms near where they touch the body (not where the arms are attached to the anthropometer). d. With the top section of the anthropometer measure to the nearest 0.1 cm the maximum breadth of the body at the level of the greater femoral trochanters. This is a bone-to-bone measurement taken over the examinee's gown. Elbow Breadth a. Have the examinee stand with his feet together in the standard erect position and extend his right arm forward until it is perpendicular to his body. b. Have him bend his arm so the angle at the elbow forms 90 with his fingers pointing up and the dorsal part of his wrist toward you. c. With the sliding calipers in the same plane as the axis of the upper arm, measure to the nearest 0.1 cm the greatest breadth across the elbow joint. This is a bone-to-bone measurement across the epicondyles of the humerus and is usually taken at an oblique angle because the inner condyle is lower than the outer condyle. Be careful that the calipers do not slide off the epicondyles. Upper Arm Girth a. Have the examinee stand with his feet together in the standard erect position and with his right arm flexed 90 at the elbow. b. Mark the lateral edge of the acromial process. Place the insertion tape along the posterior upper arm so that the same number appears on the tape at the acromial process of the scapula as at the olecranon process of the ulna. Mark the midpoint of the upper arm which is indicated by the zero point (black triangle) on the tape. c. Have the recorder mark the examinee's arm at the level of the zero point on the tape. It is of paramount importance to take this measurement accurately since the midpoint of the arm is the level at which both the arm girth and triceps skinfold measurements are taken. d. Have the examinee relax his elbow so his arm hangs freely at his side. e. Place the steel tape so it encircles the arm at the marked point and measure the circumference to the nearest 0.1 cm. The tape should rest firmly on the skin surface but should not compress the skin. Triceps Skinfold a. Have the examinee stand with his feet together in the standard erect position, relax his shoulder, and let his arm hang freely at his side. b. Mark a point on the right midtriceps in the same place as the midhumeral point used for the upper arm girth and perpendicular to the olecranon process of the ulna. c. Grasp a fold of skin and subcutaneous tissue firmly with thumb and forefinger approximately 1 cm above this level, and draw it directly back from the body making sure that no muscle tissue is included in the fold. The crest of the fold should be parallel to the long axis of the arm. d. Apply the calipers at the level of the point marked earlier and indented directly below the thumb and forefinger, and measure the fold to the nearest 0.5 mm without releasing the fingers. e. Take a second measurement; if the two disagree, continue taking measurements until you get two that agree to within 0.5 mm. Subscapular Skinfold a. Have the examinee stand with his feet together in the standard erect position and relax his shoulders and arms. b. Palpate the inferior angle of the scapula. Grasp a fold of skin and subcutaneous tissue directly above the angle firmly with the thumb and forefinger, and draw it straight back from the body making sure that no muscle tissue is included in the fold. The fold should parallel natural cleavage lines of the skin which are often lines about 45 from the horizontal extending medially upward. c. Apply the calipers about 1 cm directly below the thumb and forefinger and measure the fold to the nearest 0.5 mm without releasing the fingers. d. Take a second measurement; if the two disagree, continue taking measurements until two agree to within 0.5 mm. Iliac Crest Skinfold a. Have the examinee stand with his feet together in the standard erect position. b. Palpate the right suprailiac crest and pull a fold of skin and subcutaneous tissue directly above the crest. The fold should follow natural cleavage lines of the skin which are usually at 45 from the horizontal extending medially downward. c. Apply the calipers about 1 cm directly below the thumb and forefinger, and measure to the nearest 0.5 mm the thickness of the fold taken over the right crest at the midaxillary line but perpendicular to it. d. Take a second measurement; if the two disagree, continue taking measurements until two agree to within 0.5 mm. Medial Calf Circumference a. Have the examinee sit on the measuring table facing the doorway with his leg hanging loosely. b. Place the steel tape on a line between the distal process of the femur and the distal process of the tibia, and have the recorder make a vertical line along the edge of the tape at about the middle of the leg. c. Encircle the calf of the leg with the steel tape at what appears to be its maximum circumference. Move the tape up and down the leg slightly to confirm that you have the maximum circumference. Have the recorder mark along the top edge of the tape a horizontal line that intersects the vertical line drawn previously. d. Keeping the tape taut without compressing the skin, measure the circumference to the nearest 0.1 cm. Medial Calf Skinfold a. Have the examinee sit on the measuring table with his leg hanging loosely. b. Grasp a fold of skin and subcutaneous tissue about 1 cm above the intersection of the markings on the leg. c. Place the skinfold calipers at the level of the horizontal line and indented directly below the thumb and forefinger, and measure to the nearest 0.5 mm the thickness of the skinfold. d. Take a second measurement; if the two disagree, continue taking measurements until two agree to within 0.5 mm. Handedness Ask the examinee whether he is right-handed or left-handed and record his answer by checking the correct box. Sitting Height a. Have the examinee sit as far back on the measuring table as he can so that the backs of his knee joints (popliteal fossae) are at the front edge of the table. Have him sit erectly with his eyes straight ahead and the infraorbital meatal line parallel to the table top (that is, eyes in the horizontal plane looking straight ahead). Check with the recorder on the examinee's position before making the measurement. b. Grasp the examinee laterally under the mastoid processes and under the mandible. Lift the examinee gently to a maximal sitting height. c. While maintaining the examinee's head position with one hand, bring the caliper arm down firmly against the midline of the examinee's head. You might have to compress some hairstyles. d. Take the measurement to the nearest 0.1 cm with your eyes at the same level as the caliper arm. Do not make the reading at an angle. Short technicians should stand on the stool available in the measuring room. Procedure for Measuring Children Under Eight Years Old Before and After Measuring a. Before starting the measurements, record on the control record the examiner number and the time the procedure begins. Record on the body measurement form the examiner and recorder numbers, and the age and sex of the examinee. b. After finishing the measurements, record the time on the control record; and complete the date, age, sex, height, and weight sections on the Report of Findings to Physician page of the chart. Standing Height (Two Through Seven Years Old) Use the same procedure as that for older examinees. Weight Use the same procedure as that for older examinees. Biacromial Breadth a. Stand the child on the foot stool (placed in the center of the room) so that you can take the measurements with your eyes at about the same level as the caliper arms. b. Otherwise, use the same procedure as that for older examinees. Biiliac Crest Breadth a. Stand the child on the foot stool (placed in the center of the room) so that you can take the measurements with your eyes at about the same level as the caliper arms. b. Otherwise, use the same procedure as that for older examinees. Bitrochanteric Breadth a. Stand the child on the foot stool (placed in the center of the room) so that you can take the measurements with your eyes at about the same level as the caliper arms. b. Otherwise, use the same procedure as that for older examinees. Elbow Breadth Use the same procedure as that for older examinees except that the child may be either standing on the footstool or sitting. Upper Arm Girth a. Stand the child on the foot stool (placed in the center of the room) so that you can take the measurements with your eyes at about the same level as the caliper arms. b. Otherwise, use the same procedure as that for older examinees. Triceps Skinfold a. Stand the child on the foot stool (placed in the center of the room) so that you can take the measurements with your eyes at about the same level as the caliper arms. b. Otherwise, use the same procedure as that for older examinees. Subscapular Skinfold a. Stand the child on the foot stool (placed in the center of the room) so that you can take the measurements with your eyes at about the same level as the caliper arms. b. Otherwise, use the same procedure as that for older examinees. Iliac Crest Skinfold a. Stand the child on the foot stool (placed in the center of the room) so that you can take the measurements with your eyes at about the same level as the caliper arms. b. Otherwise, use the same procedure as that for older examinees. Medial Calf Circumference Use the same procedure as that for older examinees. Medial Calf Skinfold Use the same procedure as that for older examinees. Handedness If the child is old enough, ask him whether he is right-handed or left-handed and record his answer by checking the correct box. Otherwise, question the child's parent or guardian to obtain the information. Sitting Height (Two Through Seven Years Old) a. Have the child sit erectly on the measuring table with his eyes directed straight ahead (the eyes should be in a horizontal plane looking straight ahead). The child should sit as far back on the table as he can so that the backs of his knee joints (popliteal fossae) are in contact with the front edge of the table. Check with the recorder on the child's position before making the measurement. Younger children need to be encouraged to sit up straight, and you might have to give support to a younger child. First, straighten out his back by placing your right hand over the upper part of the chest and your left hand over the lumbar area nd pushing gently. Then, grasp the child laterally under the mastoid processes and under the mandible. Lift the child to a maximal sitting height. Be sure that the child's hands are placed in his lap to avoid his rendering you any assistance in elevating himself by using them. b. After checking the child's position with the recorder and while maintaining head position with one hand, bring the caliper arm firmly against the midline of the examinee's head. You might have to compress some hairstyles. c. Take the measurement to the nearest 0.1 cm with your eyes at the same level as the caliper arm. Chest Circumference Two Through Seven Years Old, Standing (1) Have the child stand on the footstool in the standard erect position with his feet together. (2) Pass the steel tape around the chest at the level of the nipple line so that it is at a right angle to the longitudinal axis of the body. (3) Have the recorder see that the tape is against the child's body just below the angles of the scapula. (4) Measure to the nearest 0.1 cm the chest circumference at midrespiration, with the examinee breathing normally and with his arms relaxed at his sides. Three Years Old and Under, Supine (1) Have the child lie supine on the infant measuring board. (2) Put the tape around the chest at nipple level at a right angle to the longitudinal axis of the body. (3) Take the measurement to the nearest 0.1 cm at normal midrespiration. Head Circumference a. Have the child either sit on the footstool or stand for this measurement. b. Steady the child's head and place the steel tape firmly around the frontal bones (forehead) just above but not including the supra-orbital ridges, passing the tape around the head just above the ears on each side, and laying it over the maximum occipital prominence at the back of the head. c. Have the recorder hold the tape on the maximal occipital prominence once the tape has been positioned correctly. d. Pull the tape firmly to compress the hair and underlying soft tissues. e. Measure the head circumference to the nearest 0.1 cm. Recumbent Length (Three Years Old and Under) a. Have the child lie on his back on the infant measuring board. b. Find another technician to help take this measurement. One technician holds the child's head in the Frankfort plane (that is, eyes straight ahead, in this case straight upward so that the plane they form is parallel to the movable footboard) and applies gentle traction to bring the head into contact with the fixed headboard. The second technician holds the child's legs by placing one hand firmly over the knees. the child's toes should point directly upward. Then, while applying downward pressure to the legs (to prevent the knees from flexing), the second technician brings the movable footboard to rest firmly against the child's heels. You may need a third person to help with restless infants so you can take measurements as quickly as possible and maintain accuracy. c. Read the measurement to the nearest 0.1 cm from the digital counter on the measuring footboard. Crown-Rump Length (Three Years Old and Under) a. Have the child lie on his back on the infant measuring board with his hips bent at a right angle. b. Find another technician to help take this measurement. One technician holds the child's head in the Frankfort plane and applies gentle traction to bring the head into contact with the fixed headboard. The second technician supports the child's legs under the flexed knees and brings the movable footboard to rest against the child's buttocks with firm pressure. c. Read the measurement to the nearest 0.1 cm from the digital counter on the measuring footboard. Unusual Occurrence Form The unusual occurrence form is used to describe the reasons why parts of the examination were not obtained or why they may have been done in a nonstandard way. For instance, it should identify infants on whom data could not be obtained because of uncontrollable behavior, examinees on whom right-side measurements could not be taken, and all refusals. This form should include the sample numbers of all infants (under two years old) on whom height photos were not taken. Conditions affecting the exam should also be listed here, for example: "SP pregnant" or "right side atrophy due to paralysis." Field Checks and Calibrations Calipers Bitrochanteric Calipers Calibrate the bitrochanteric calipers at the beginning of the stand and once a week during the stand as follows: (1) Separate the arms of the calipers to a randomly chosen whole number measurement. Place the steel measuring tape between the inner edges of the caliper arms to measure the distance between them. This measurement should be the same as the numerical measurement indicated on the anthropometer. If it is not, make sure that the two sections of anthropometer rod fit tightly together at the joint. Also, make sure that the fixed caliper arm fits snugly against the top end of the anthropometer. An adjustment can be made by unscrewing the Allen screw in the top of the fixed caliper arm holder and pressing the holder and rod firmly together. (2) Check the linearity of the anthropometer's arms by placing the skinfold step wedge tightly between the inner edges at the base of the arms. Holding the arms immobile, move the step wedge toward the arm tips. If the arms are bent, a widening or narrowing of the space will be noticed as the step wedge is moved. The separation of the caliper arms should not exceed 1.0 mm. If it does, replace the bent caliper arms with a spare set. Skinfold Calipers Calibrate the skinfold calipers before each examining session as follows: (1) Make sure the reading on the scale is 0.0 when the caliper arms are in a closed position. (2) Place the step wedge standard between the caliper arms at each of the five steps, and check that the reading on the scale corresponds to the standard measurement. (3) If the calipers are not accurate, adjust them by pressing firmly on the arms while the caliper arms are in place on the step level that is out of calibration. (4) Record the measurement taken at each step on the body measurement calibration log sheet under the appropriate heading. An identical calibration should be done on the spare set of skinfold calipers and the corresponding measurements also recorded on the calibration log sheet. Be careful to record the calipers' values on the correct device identification line. (The spare is not always the B instrument.) (5) If the calipers are 1 mm or more out of calibration at any level, use the other set of calipers and return the faulty set to headquarters. (6) If the calipers become too loose, use the spare set of calipers and return the faulty set to headquarters. Elbow Breadth Calipers (1) Calibrate the elbow breadth calipers at the beginning of the stand and once a week during the stand, using the same procedure used for bitrochanteric anthropometer calibration. Be sure to calibrate the "flat" end portion of the calipers (as opposed to the "sharp end" portion). (2) If any abnormality is noticed, use the spare set of elbow breadth calipers and notify the chief technician about the condition. Sitting Height Anthropometer Beginning of Stand and Weekly During the Stand (1) Check that the sliding arm is perpendicular to the upright bar and is not bent. If the arm is bent, use the spare caliper arm and notify the chief tech. (2) Adjust the caliper arm to a randomly selected whole number measurement. Place the edge of the metal base even with the edge of the sitting height table. (3) Using the metal tape, measure from the lower edge of the caliper arm to the top edge of the sitting height table. This measurement should correspond to the anthropometer reading. (4) Move the metal base backward on the sitting height table so that the tip end of the caliper arm is at the edge of the table. Again use the metal tape to measure from the lower edge of the caliper arm to the top edge of the sitting height table. This measurement should correspond to the anthropometer reading. (5) If either of the tape measurements differs from the anthropometer reading, check that the correct side of the caliper arm holder is being used. If so, exchange the caliper arm for the spare arm; inform the chief tech; and repeat the entire calibration process with the spare caliper arm in place. Daily (1) See that the bottom of the anthropometer is perfectly flush with the undersurface of the metal stand. (Do not handle the anthropometer by the rod sections alone; they are apt to be wrenched from the base or become separated at the joint between the two rods.) (2) See that the instrument, when properly mounted in the base, stands vertically without support. If it doesn't, check that the metal base screw responsible for holding the metal rod sections upright is screwed tightly against the rod. Check that the rod is sitting flush against the supporting side of the metal base. If these conditions are both met and the anthropometer still does not stand vertically, use the spare anthropometer set and notify the chief tech about this condition. (3) See that the anthropometer numbers read in the correct sequence and the movable arms slide freely without slipping. Infant Measuring Board a. Check the infant measuring board at the beginning of each stand by placing a steel tape beside the steel tape mounted on the board to check that the steel tape on the board has not been stretched or bent during transit. If it has, inform the chief tech and the biomedical engineer. The tape will need to be repositioned. b. At the beginning of the stand and before each examining session, move the footboard of the baby board to some point along its length chosen at random. This point should alternate between high and low numbers from session to session to assure total calibration. Check the digital counter reading against the steel tape reading to make sure they agree. Record the counter reading on the daily calibration log sheet under the appropriate heading. If the two readings do not agree, inform the chief tech who will be responsible for the following correction process. (1) Place the footboard at some randomly chosen whole number. (2) Unscrew and remove the digital counter cover plate from the side of the infant measuring board. Remove the digital counter from its position on the footboard. (3) Using the small gear located on the right side of the counter, rotate the digits until they agree with the location of the footboard. (4) Without allowing the digits on the counter or the footboard to move, gently position the counter back into place on the footboard making sure to mesh the small gear on the counter with the larger gear located on the footboard. (5) Replace the digital counter cover plate. (6) Move the footboard from one end of the infant measuring board to the other, to make sure that the digital counter and the tape measurements agree for the entire length of the board. c. Record beginning of stand and all postrepair calibrations in the log book under the correct headings. Height Scale Beginning of Stand Checks (1) Check that the upright bar and attached tape measure have not been damaged. (2) Check that the horizontal bar is firmly attached to the upright sliding section and that the section operates smoothly. If it doesn't, clean the upright bar with white vinegar. (3) Check the Polaroid camera and light to see that they produce optimum photos. Calibration Calibrate the height scale at the beginning of each stand before examinations begin and at the end of each stand after all examinations are done as follows: (1) Place the sitting height anthropometer at the middle of the height scale base. (2) Place the horizontal bar of the height scale firmly against the anthropometer top. (3) Take a Polaroid photograph of the height scale tape. The measurement recorded should be 104 cm. If it's not, adjust the sighting window on the height scale until the measurement does agree and rephotograph the scale. (4) Record on the back of the photo the stand number, location, technician number, date, and the level set on the sitting height anthropometer for the calibration. (5) Give the photo to the chief tech for shipment to the Quality Control Section at headquarters. Weight Scale Digital Weight Scale Calibrate the weight scale at the beginning of each stand before examinations begin and at the end of each stand after all examinations are done as follows: (1) Place the electronic digital system in the pound mode by pressing the LB/KG button on the keyboard until the readout is in tenths. If the digital readout does not register "000.0," press the zero key to automatically balance the scale at zero. (2) After zeroing the scale properly, print the zero weight on a sheet of 8 1/2" x 11" paper. (3) Place calibration weights on the scale in increments of 25 pounds, starting with 25 and continuing to 250. (4) Print the weight in pounds at each increment on the calibration paper by pressing the PRINT key on the time/date unit. At 100 pounds, print the weight in pounds and in kilograms to attest to the accuracy of the pound/kilogram conversion. (5) If the scale is out of calibration by at least one half-pound at more than three levels, inform the chief tech. Professional servicing will be necessary. (6) When a satisfactory calibration is obtained, record the stand number, stand location, date, and tech number on the sheet and give it to the chief tech to send to headquarters. Printer The printer comprises a bank of numbers and letters that indicate, from left to right, time (AM or PM), date, and weight. To set the time/date function displayed in the LED on the front panel, do the following: (1) Plug the power cord into the power outlet. (2) Find the two pushbuttons on the rear panel of the panel of the printer above the attached power cable. The top one is the "set" button; the bottom one is the "advance" button. (3) Press the "set" button to cause the rightmost LED digit to begin blinking. Press the "advance" button to advance the numerals until the correct year designation appears. Press "set" once again to fix that numeral in the LED and cause the second digit from the right to begin blinking. (4) Follow the above process through the six-digit field that represents the date and the four-digit field that represents the time. Although the time must be set according to a 24-hour clock, time will appear on the LED and the printout according to a twelve-hour clock, AM and PM. (5) When all the digits have been correctly set, press the "set" button twice to start the timing operation. Spare Scale If it is necessary to use the spare scale because the electronic digital scale is out of order, calibrate it before using according to the following instructions: (1) Turn the scale lock at the back of the unit to a horizontal position to unlock the spring mechanism. (2) Zero the scale if the trailer is not level. Turn the knob on the left side of the scale gentle until the scale reads "0.00." A reading of "E.EE" indicates you have adjusted the scale to below zero. (3) After zeroing the scale properly, print the zero weight on a sheet of 8 1/2" x 11" paper. (4) Place calibration weights on the scale in increments of 25 pounds, starting with 25 and continuing to 250. (5) Print the weight in pounds at each increment on the calibration paper. (6) If the scale is out of calibration by a constant amount at all increments, correct the error with the adjustment knob on the left side of the scale. (7) If the scale is out of calibration by at least a half-pound at more than three weight increments but not out consistently at all stations, call the company for servicing. (8) When a satisfactory calibration is obtained, record the stand number, stand location, date, and tech number on the sheet; and give it to the chief tech to send to headquarters. (9) When the electronic igital scale has been repaired and the spare scale is no longer needed for data collection, turn the scale lock at the back of the unit to a vertical position. Daily Check (1) Have the tech responsible for the body measurement station weigh himself daily to roughly check the accuracy of the weight scales. (2) If there is any reason to believe the scales are not accurate, do a complete recalibration. The recording of the calibration should be sent to the Quality Control Section at headquarters. Cleaning of equipment a. At the beginning of each stand and during the stand as necessary, wipe the anthropometer, calipers, and tape measures with white vinegar to allow their sliding parts to move more freely. b. Clean the equipment with alcohol at the end of each examining day. c. Clean the camera roller bars periodically according to the following instructions to assure uniform spreading of the photo developing agent. (1) Open the back of the camera by releasing the lever on the bottom panel of the camera. (2) Grasp the roller springs on the top and bottom of the roller assembly and pull them straight outward, thus allowing the roller bars to swing free of the inside camera body. (3) Clean the roller bars thoroughly using alcohol on gauze to remove the chemical residue. (4) Put the roller assembly against the back panel of the camera body, and press firmly at the center of the roller bars to reseat the rollers. (5) Place the back of the camera against the main body of the camera, and press on it firmly to close the camera. End of Stand Procedures Pack-Up Calibration a. Calibrate completely the weight and standing height scales as described earlier in this chapter under Field Checks and Calibrations. b. Give the calibration sheet to the chief tech to send to headquarters. Also send the skinfold daily calibration sheet to headquarters at the end of the stand. Pack-Up Procedures Calipers (1) Dismantle the bitrochanteric and sitting height anthropometer calipers and place each of these and the elbow breadth calipers in the traveling case. Store the case and the sitting height anthropometer base in the body measurement table. (2) Place the skinfold calipers in their protective case, and store it in the body measurement table drawer. Weight Scale (1) Unplug the power cord, and check that the weight scale is in a vertical position. (2) Move the weight blocks on the front of the scale to the far right side, and tape them in position. (3) Immobilize the scale platform by inserting table paper snugly between the platform and the scale base. Printer (1) Unplug the power cord from the wall outlet. (2) Disconnect the input cable to the scale, and tape the cable onto the printer shelf. (3) Put the printer on the floor. Height Scale (1) Unplug the light from the power outlet. (2) Place the light against the camera-holding bar and tape it into position. (3) Raise the horizontal bar to the top of the upright bar and tape it into position. (4) Be sure that the camera is securely fastened down for transit. Body Measurement Table (1) Close and lock the drawers and cabinet doors. (2) Place the webbing strap around the table and secure the ends to the wall brackets. 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