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Public Health Rep. 2010 Sep-Oct; 125(5): 763–764.
PMCID: PMC2925017

NCHS Dataline

A new study by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) links smoking and depression. Data from the National Health and Nutrition Examination Survey, conducted by NCHS, shows that adults with depression were more likely to smoke, more likely to be heavy smokers, and less likely to quit smoking. Another new NCHS study analyzes visits to the emergency department by residents of nursing homes and determines that a portion of those visits was potentially preventable. A new study profiles the U.S. population aged 70 years and older with regard to vision, hearing, balance, and other sensory impairments, finding that sensory problems increase with age. And a Board of Scientific Counselors meets periodically to provide advice and make recommendations regarding the goals, programs, strategies, and priorities of NCHS.

SMOKING AND DEPRESSION

About 7% of adults aged 20 years and older experienced depression between 2005 and 2008, based on data from the National Health and Nutrition Examination Survey (NHANES). NHANES collects data through standardized health examinations and health interviews administered to a nationally representative sample of the civilian, noninstitutionalized population. NHANES also collects information on current and former smoking patterns, and a new report, “Depression and Smoking in the U.S. Household Population Aged 20 and Over, 2005–2008,” examines the relationship between smoking and depression.1

The survey found that adults aged 20 years and older with depression were more likely to be cigarette smokers than those without depression. Overall, individuals with depression were nearly twice as likely (43%) to smoke than those without depression (22%). For both women and men and among those in all age groups, people with depression had higher smoking rates than those without depression. Men had higher rates of smoking than women, but among those with depression, smoking rates for men and women were similar. There was also a relationship between the degree of depression experienced by individuals and the likelihood that they were smokers. Adults with even mild depressive symptoms were more likely to smoke, and smoking rates increased as symptoms of depression became more severe.

The survey findings showed that adults with depression were more likely to be heavy smokers than those without depression. About one-quarter of those with and without depression smoked a pack of cigarettes a day, but almost twice as many of those with depression smoked more than a pack a day compared with smokers without depression (28% vs. 15%). Another indicator of heavy smoking is to smoke the first cigarette of the day within five minutes of awakening. Half of adult smokers with depression had the first cigarette within five minutes of awakening compared with 30% of smokers without depression. In addition, among those who had ever smoked, adults with depression were less likely to have quit smoking than those without depression.

EMERGENCY DEPARTMENT VISITS BY NURSING HOME RESIDENTS

The National Nursing Home Survey is a periodic survey of nursing home care in the United States. The survey collects data on nursing homes' services and staff and the residents they serve based on a national sample of nursing homes. Information on residents includes demographic characteristics, conditions and diagnoses, and care received. The 2004 survey, “Potentially Preventable Emergency Department Visits by Nursing Home Residents: United States, 2004,” reported that 8% of U.S. nursing homes had an emergency department (ED) visit in the past 90 days.2

Other research has identified conditions that may lead to potentially preventable visits to the ED among nursing home residents. Fever, chest pain, heart disease (mainly heart failure), mental status changes, gastrointestinal bleeding, urinary tract infections, metabolic disturbances, pneumonia, diseases of the skin, and injuries due to falls have been identified as reasons for potentially preventable visits to an ED. Researchers state that some of these conditions can be better treated in the nursing home than in the ED, and that other conditions, such as falls and pneumonia, may have been avoided by preventing the precipitating event. The report's authors applied that research to data on visits residents made to EDs in 2004 and found that about 40% were potentially preventable. Injuries from falls were the most common conditions, accounting for more than one-third of potentially preventable ED visits by nursing home residents. Symptoms of heart conditions accounted for almost 20% and pneumonia for 12% of the potentially preventable ED visits.

SENSORY IMPAIRMENTS AMONG OLDER ADULTS

The prevalence of sensory impairments increases with age, according to a new NCHS report, which presents the latest data on vision, hearing, balance, and other sensory impairments among older adults—aged 70 and older—based on examination components of NHANES.3 Major findings show that among those aged 70 and older:

  • One out of six has visual impairment, with visual acuity ≤20/50, even when wearing corrective lenses.
  • One out of four has impaired hearing, meaning that they are not able to hear and repeat words spoken in a normal voice from across a quiet room.
  • One out of four has loss of feeling in the feet, reflecting lower extremity insensate peripheral sensory neuropathy.
  • Three out of four have abnormal postural balance testing.

Vision and hearing impairments each double and the loss of feeling in the feet increases by 40% in people aged 80 years and older compared with people aged 70–79 years. Men are more likely than women to have hearing impairments and loss of feeling in the feet. On the other hand, women are slightly more likely than men to have a balance impairment. Men and women are equally likely to have vision impairments. Differences were also noted among racial/ethnic groups. Non-Hispanic black and Mexican American people have a higher prevalence of vision impairment than non-Hispanic white people. Hearing problems are more frequent among non-Hispanic white and Mexican American people than among non-Hispanic black people. Mexican American individuals have the highest rate of balance problems. Vision and balance problems are more common among older American adults living below the poverty level. Vision and hearing problems could be improved by new or better glasses and by using a hearing aid.

BOARD OF SCIENTIFIC COUNSELORS

The Board of Scientific Counselors (BSC) is charged with providing advice and making recommendations to the Secretary of the Department of Health and Human Services, the Director of CDC, and the Director of NCHS regarding the scientific and technical program goals, objectives, strategies, and priorities of NCHS. The BSC provides advice and guidance on statistical and epidemiologic research and activities that focus on various health issues. Additionally, the BSC makes recommendations about opportunities for NCHS programs to examine and employ new approaches to monitoring and evaluating key public health, health policy, and welfare policy changes. The BSC has undertaken an ongoing series of reviews of the major NCHS programs, using external panels of experts. A number of reviews have been completed and are on the BSC website (http://www.cdc.gov/nchs/about/bsc.htm). The next BSC meeting will be held September 23–24, 2010, at NCHS in Hyattsville, Maryland.

Footnotes

NCHS Dataline was prepared by Sandra S. Smith, MPH, Communications Consultant at the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, and Jeffrey H. Lancashire, NCHS Public Affairs Officer.

REFERENCES

1. Pratt LA, Brody DJ. NCHS Data Brief No. 34. Hyattsville (MD): National Center for Health Statistics (US); 2010. Apr, Depression and smoking in the U.S. household population aged 20 and over, 2005–2008.
2. Caffrey C. NCHS Data Brief No. 33. Hyattsville (MD): National Center for Health Statistics (US); 2010. Apr, Potentially preventable emergency department visits by nursing home residents: United States, 2004.
3. Dillon CF, Gu Q, Hoffman HJ, Ko C-W. NCHS Data Brief No. 31. Hyattsville (MD): National Center for Health Statistics (US); 2010. Apr, Vision, hearing, balance, and sensory impairment in Americans aged 70 years and over: United States, 1999–2006. [PubMed]

Articles from Public Health Reports are provided here courtesy of SAGE Publications