Data from the Series 10 NATIONAL HEALTH SURVEY Number 6 9 Acute Conditions Incidenceand AssociatedDisability United States - July 1968-June1969 Statistics on the incidence of acute conditions and the associated days of restricted activity, bed disability, and time lost from work and school, by age, sex, calendar qunrter, residence, and geographic region, based on data collected in household interviews during the period July 196%June 1969. DHEW Publication No. (HSM) 72-1036 U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Health Services and Mental Health Administration National Center for Health Statistics Rockville, Md. February 1972 Vital and Health Statistics-SerieslO-No. 69 For sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 2M02- Price 65 et& NATIONAL CENTER FOR HEALTH STATISTICS THEODORE D. WOOLSEY, Director PHILIP S. LAWRENCE, Sc.D., Associate Director OSWALD K. SAGEN, Ph.D., Assistant Director for Health Statistics Development WALT R. SIMMONS, M.A., Assistant Director for Research and Scientific Development JAMES E. KELLY, D.D.S., Dental Advisor EDWARD E. MINTY, Executive Officer ALICk HAYWOOD, Information Officer DIVISION OF HEALTH INTERVIEW STATISTICS ELIJAH L. WHITE, Director ROBERT R. FUCHSBERG, Deputy Director RONALD W. WILSON, Chief. Analysis and Reports Branch KENNETH W. HAASE, Chief, Survey Methods Branch COOPERATION OF THE BUREAU OF THE CENSUS Under the legislation establishing the National Health Survey, the Public Health Service is authorized to use, insofar as possible, the services or facil­ ities of other Federal, State, or private agencies. In accordance with specifications established by the Health Interview Sur­ vey, the Bureau of the Census, under a contractual arrangement, participates in most aspects of survey planning, selects the sample, and collects the data. Vital and Health Statistics-Series1 O-No. 69 DHEW Publication No. (HSM) 72-1036 Library of Congress Catalog Card Number 65-60041 CONTENTS Page Introduction _--_-_-------_---_______________________------------------ 1 Source ofData-------------------------------------------------------- 1 Classification of Acute Conditions-------------------- ___________________ 2 Comparison with July 1967-June 1968----------------------------------- 2 Incidence of Acute Conditions by Sex and Age----------------------------- 4 5 Seasonal Variation: Calendar Quaj-ter------ _______ - _____________________ 6 7 List of Detailed Tables-------- _____ ---_--_-_- _________________________ 8 Appendix I. Technical Notes on Methods------------------------------- 43 Background ofThisReport------------------------------------------- 43 Statistical Design of the Health Interview Survey----------------------- 43 General Qualifications---------------------------------------------- 44 Reliability of Estimates ____________-_-_- ____-_-_____________________ 45 Guide to Use of Relative Standard Error Charts------------------------ 47 Appendix II. Definitions of Certain Terms Used in This Report----------- 54 Terms Relating to Conditions _______------------_--- _____- __________- 54 Terms Relating to Disability-- ______---_-_-_--- ___________- __________ 56 Demographic, Social, and Economic Terms---------------------------- 56 Appendix III. Probe Questions on Disability Days and Physician Visits During P-Week Reference Period, and Condition Pages------------------------ 58 iii SYMBOLS Data not available ________ --_--_- _________ ___ Category not applicable------------------- . Quantity zero---------------------------- _ Quantity more than 0 but less than 0.05----- 0.0 Figure does not meet standards of reliability or precision (more than 30- percent relative standard error)--------- * iv ACUTE CONDITIONS INCIDENCE AND ASSOCIATED DISABILITY Charles S. Wilder, Division of He&h Intevuiew Statistics INTRODUCTION ports on acute conditions will continue to cover the period from July of one year to June of the During the 12 months ending in June 1969, next. Acute condition data is also summarized there was an estimated incidence of 406.2 million in the current estimates reports, which are acute illnesses or injuries requiring either medi­ for the calendar year. cal attention or reduced daily activity. This volume of new cases of acute conditions produced an an­ nual incidence rate of 206.8 per 100 persons in the SOURCE OF DATA civilian, noninstitutional population of the United The information in this report is derived States, The rate for the current year was 9.2 from household interviews conducted by the Health percent higher than the estimate of 189.4 con­ Interview Survey in a probability sample of the ditions per 100 persons per year during July civilian, noninstitutional population of the United 1967-June 1968. Contributing substantially to the States. The sample is designed so that interviews increased incidence was the Hong Kong influenza are conducted during every week of the year by epidemic in the latter part of 1968. trained personnel of the U.S. Bureau of the Census. This report from the Health Interview Survey During July 1968-June 1969, the sample was com­ is part of an annual series reporting on new cases posed of about 42,000 households containing about of acute illnesses or injury during the year starting 134,000 persons living at the time of the interview. in July and ending in June. The last published re- A description of the design of the survey, of port, Series 10, &lo. 54, covered the period July the methods used in estimation, and of the general 1967-June 1968. During that period information qualifications of the data obtained from surveys was collected using two data collection proce­ is presented in appendix I. Since estimates shown dures, the person approach for half of the sample in this report are based on a sample of the popu­ and the condition approach for the other half. These lation rather than on the entire population, they procedures are described in Series 10, No, 54, are subject to sampling error. Therefore par­ and in the current estimates report for 1967, ticular attention should be paid to the section en- Series 10, No. 52. This report covers the period titled “Reliability of Estimates.” Sampling errors July 1968-June 1969, and the person approach for most of the estimates are of relatively low was used as the data collection procedure. magnitude. However, where an estimated number Data is being collected in the Health Inter- or the numerator or denominator of a rate or per­ view Survey on a calendar year basis starting centage is small, the sampling error may be high. with 1968. However, because the epidemiologic Certain terms in this report are defined in year for acute respiratory illnesses peaks during appendix II. Some of the terms have specialized the late fall and winter months, the series of re- meanings for the purpose of the survey. For ex- ample, estimates of the incidence of acute con­ symptoms and ill-defined conditions, impair ­ ditions include, with certain exceptions, those ments, late effects, and eye diseases. con&tions which had started within the 2 weeks Acute illnesses and injuries reported during prior to the week of interview and which had in­ July-December 1968 were coded according to the volved either medical attention or restricted ac­ Seventh Revision of the International Classifi­ tivity. The exceptions listed in appendix II are cation of Diseases (ICD). The conditions reported certain conditions such as heart trouble and di­ during January-June 1969 were coded according abetes which are always considered chronic, re­ to the Eighth Revisiomlnternational Classification gardless of duration or onset. of Diseases, Adapted for Use in the United State:; Annual estimates of the number of disability (ICDA). days associated with each acute condition are de- Tables l-3 list five main categories of acute: rived from the number of such days experienced illnesses and injuries as well as selected sub-. during the 2-week period prior to the week of groups within each main category. The rubrics interview and include all those reported even if from ICD and ICDA which are included in each the illness causing the disability had its onset category and subgroup are shown in appendix II, prior to the 2-week period: Since any particular Principal changes in the Eighth Revision which day of disability may be associated with more than would be expected to affect the data on incidence one condition, the sum of days for all conditions in the detail shown in table 1 by making a sizeable adds to more than the total number of person-days shift in frequency from one condition subgroup to of disability. another are as follows:i The questionnaires used by the Health Inter- Diarrhea1 conditions: Conditions coded to view Survey during July 1968-June 1969are illus­ 1. 571 (except noninfective conditions) and trated in the current estimates reports of calendar 785.6 in the ICD are coded to 008 or 009 years 1968 and 1969 (Series 10, Nos. 60 and 63). in the ICDA. Appendix III shows the probe questions used to 2. Headache (except migraine headache): find out about disability days and physician visits Conditions in 791 in ICD are coded to which occurred during the 2 weeks prior tointer­ 306.8.in ICDA if reported in the intervievr view week, Additional information about each re- to be due to nerves or as “nervous head- ported condition is obtained on the condition page, ache.” also illustrated in appendix III. The incidence rates for the previous six In general, it was felt that because