Publications by authors named "Jennifer H Madans"

13 Publications

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A Framework for Monitoring Progress Using Summary Measures of Health.

J Aging Health 2016 10;28(7):1299-314

National Center for Health Statistics, Hyattsville, MD, USA.

Objective: Initiatives designed to monitor health typically incorporate numerous specific measures of health and the health system to assess improvements, or lack thereof, for policy and program purposes. The addition of summary measures provides overarching information which is essential for determining whether the goals of such initiatives are met.

Method: Summary measures are identified that relate to the individual indicators but that also reflect movement in the various parts of the system.

Results: A hierarchical framework that is conceptually consistent and which utilizes a succinct number of summary measures incorporating indicators of functioning and participation is proposed.

Discussion: While a large set of individual indicators can be useful for monitoring progress, these individual indicators do not provide an overall evaluation of health, defined broadly, at the population level. A hierarchical framework consisting of summary measures is important for monitoring the success of health improvement initiatives.
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http://dx.doi.org/10.1177/0898264316656510DOI Listing
October 2016

Comments on Sabariego et al. Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates. Int. J. Environ. Res. Public Health, 2015, 12, 10329-10351.

Int J Environ Res Public Health 2015 Dec 22;13(1):ijerph13010065. Epub 2015 Dec 22.

National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, USA.

In the article, Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates, in Volume 12 of the Journal International Journal of Environmental Research and Public Health, Carla Sabariego et al. [1] raise several issues regarding the use of the short set of questions developed by the Washington Group on Disability Statistics (WG) as compared with the approach to disability measurement proposed through the Model Disability Survey (MDS). We address these below. [...].
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http://dx.doi.org/10.3390/ijerph13010065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730456PMC
December 2015

Methods to improve international comparability of census and survey measures of disability.

Disabil Rehabil 2013 Jun 1;35(13):1070-3. Epub 2012 Oct 1.

National Center for Health Statistics, Hyattsville, MD 20782, USA.

Purpose: To describe the methods used by the Washington Group on Disability Statistics (WG) to develop internationally comparable questions on disability that can be used worldwide.

Method: The WG approach to developing disability measures included careful consideration of the theoretical and conceptual issues associated with disability, translating disability concepts into measurement tools, and mixed-method evaluations of the proposed questions using both cognitive and field interviewing methodologies.

Results: Disability is a complex construct the measurement of which presents considerable challenges for survey methodologists. The Washington Group on Disability Statistics (WG), a UN Statistical Commission sponsored city group, was established to address the methodological and measurement challenges that have characterized disability statistics and to develop questions for use worldwide that will provide comparable, valid and reliable disability statistics. The WG used a variety of methods to meet these objectives and has finalized a short set disability measure for use in censuses worldwide.

Conclusions: The methodologies adopted by the WG have resulted in question sets that greatly improve the international comparability of disability statistics and will advance our understanding of disability worldwide.
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http://dx.doi.org/10.3109/09638288.2012.720353DOI Listing
June 2013

Measuring disability and monitoring the UN Convention on the Rights of Persons with Disabilities: the work of the Washington Group on Disability Statistics.

BMC Public Health 2011 May 31;11 Suppl 4:S4. Epub 2011 May 31.

National Center for Health Statistics, Hyattsville, MD 20782, USA.

The Washington Group on Disability Statistics is a voluntary working group made up of representatives of over 100 National Statistical Offices and international, non-governmental and disability organizations that was organized under the aegis of the United Nations Statistical Division. The purpose of the Washington Group is to deal with the challenge of disability definition and measurement in a way that is culturally neutral and reasonably standardized among the UN member states. The work, which began in 2001, took on added importance with the passage and ratification of the UN Convention on the Rights of Persons with Disabilities since the Convention includes a provision for monitoring whether those with and without disabilities have equal opportunities to participate in society and this will require the identification of persons with disabilities in each nation. The International Classification of Functioning, Disability and Health (ICF) developed by the World Health Organization provided a framework for conceptualizing disability. Operationalizing an ICF-based approach to disability has required the development of new measurement tools for use in both censuses and surveys. To date, a short set of six disability-related questions suitable for use in national censuses has been developed and adopted by the Washington Group and incorporated by the United Nations in their Principles and Recommendations for Population and Housing Censuses. A series of extended sets of questions is currently under development and some of the sets have been tested in several countries. The assistance of many National and International organizations has allowed for cognitive and field testing of the disability questionnaires in multiple languages and locations. This paper will describe the work of the Washington Group and explicate the applicability of its approach and the questions developed for monitoring the UN Convention on the Rights of Persons with Disabilities.
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http://dx.doi.org/10.1186/1471-2458-11-S4-S4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104217PMC
May 2011

Life Expectancy Free of Chronic Condition-induced Activity Limitations Among White and Black Americans, 2000-2006.

Vital Health Stat 3 2010 Dec(34):1-29

Objective-Life expectancy without activity limitations or active life expectancy is one of the health expectancy measures that is used to summarize population health. The measure differentiates the remaining years of life that are expected to be spent with activity limitations from expected years of life without activity limitations. The objective of this study was to estimate life expectancy with and without activity limitations for the white and black populations of the United States in the years 2000-2006, focusing on expected years free of chronic condition-induced activity limitations. Methods-Life expectancies for the total as well as the white and black populations for the years 2000-2006 were calculated separately using abridged single decrement life tables. Expected years of life with and without chronic condition-induced activity limitations were calculated using Sullivan's method. The statistical analysis is based on data from the U.S. Census Bureau and the National Center for Health Statistics. Results-Results of the study show that during the 7-year period, expected years free of chronic condition-induced activity limitations increased for the total population as well as the white and black populations of both sexes. For the total population, all males and all females, years free of chronic condition-induced activity limitations increased significantly at all ages except at 85 and over. Expected years free of chronic condition-induced activity limitations increased at age 75 and under for the white population and at age 65 and under for the black population.
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December 2010

Estimating healthy life expectancies using longitudinal survey data: methods and techniques in population health measures.

Vital Health Stat 2 2008 May(146):1-24

Objective-Summary measures of population health are statistics that combine mortality and morbidity to represent overall population health in a single index. Such measures include healthy life expectancy, also called disability-free life expectancy and active life expectancy. Healthy life expectancy can be calculated using cross-sectional or longitudinal survey data. This report presents a comprehensive discussion of a method for calculating healthy life expectancy using data from longitudinal surveys. Methods-Healthy life expectancies are calculated using the multistate life table model. Expected life in various states of health is estimated using data from the Second Longitudinal Study of Aging and the Medicare Current Beneficiary Survey to illustrate the calculation of the statistics and the discussion of data and methodology related issues. Results-The study shows that estimating summary measures of population health using longitudinal survey data provides the opportunity of using incidence rather than prevalence rates. Health measures estimated based on incidence reflect the most recent health status of the population. Models that use longitudinal survey data measure transitions from good to poor health as well as poor to good health. That is, the models account for recovery from morbidity or illness. Longitudinal survey data canalsobeusedtocalculate healthy or active life expectancies by initial health states.
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May 2008

Counts of neutrophils, lymphocytes, and monocytes, cause-specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study.

Ann Epidemiol 2005 Apr;15(4):266-71

National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.

Purpose: To examine the association of elevated counts of white blood cell types with increased risk of coronary heart disease (CHD) and death.

Methods: Data were examined from the NHANES-I Epidemiologic Follow-up Study.

Results: Relative risks for death at ages 25 to 74 comparing the upper and lower tertiles of neutrophil count were: all causes 1.29 (95% CL, 1.14, 1.47), and cardiovascular causes 1.39 (95% CL, 1.15, 1.67) after adjusting for baseline risk factors.

Conclusions: The increased risk of CHD and death from all causes and cardiovascular diseases appeared to be only partially due to effects of smoking. No association was seen for lymphocytes or monocytes.
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http://dx.doi.org/10.1016/j.annepidem.2004.08.009DOI Listing
April 2005

Bridging between two standards for collecting information on race and ethnicity: an application to Census 2000 and vital rates.

Public Health Rep 2004 Mar-Apr;119(2):192-205

Office of Analysis, Epidemiology, and Health Promotion, National Center for Health Statistics, 3311 Toledo Rd., Rm. 6415, Hyattsville, MD 20782, USA.

Objectives: The 2000 Census, which provides denominators used in calculating vital statistics and other rates, allowed multiple-race responses. Many other data systems that provide numerators used in calculating rates collect only single-race data. Bridging is needed to make the numerators and denominators comparable. This report describes and evaluates the method used by the National Center for Health Statistics to bridge multiple-race responses obtained from Census 2000 to single-race categories, creating single-race population estimates that are available to the public.

Methods: The authors fitted logistic regression models to multiple-race data from the National Health Interview Survey (NHIS) for 1997-2000. These fitted models, and two bridging methods previously suggested by the Office of Management and Budget, were applied to the public-use Census Modified Race Data Summary file to create single-race population estimates for the U.S. The authors also compared death rates for single-race groups calculated using these three approaches.

Results: Parameter estimates differed between the NHIS models for the multiple-race groups. For example, as the percentage of multiple-race respondents in a county increased, the likelihood of stating black as a primary race increased among black/white respondents but decreased among American Indian or Alaska Native/black respondents. The inclusion of county-level contextual variables in the regression models as well as the underlying demographic differences across states led to variation in allocation percentages; for example, the allocation of black/white respondents to single-race white ranged from nearly zero to more than 50% across states. Death rates calculated using bridging via the NHIS models were similar to those calculated using other methods, except for the American Indian/Alaska Native group, which included a large proportion of multiple-race reporters.

Conclusion: Many data systems do not currently allow multiple-race reporting. When such data systems are used with Census counts to produce race-specific rates, bridging methods that incorporate geographic and demographic factors may lead to better rates than methods that do not consider such factors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497618PMC
http://dx.doi.org/10.1177/003335490411900213DOI Listing
June 2004

Relation between region of residence in the United States and hypertension incidence--the NHANES I epidemiologic follow-up study.

J Natl Med Assoc 2004 May;96(5):625-34

Centers for Disease Control and Prevention, Hyattsville, MD, USA.

A number of studies have found hypertension prevalence to be higher in the southeast region of the United States than in other U.S. regions. To test the hypotheses that hypertension incidence is higher in the southeast than in other regions, and that higher levels of known hypertension risk factors in the southeast explain the difference in incidence, data from a nationally representative, longitudinal cohort study of a sample drawn from the U.S. population, the NHANES I Epidemiologic Follow-Up Study (1971-1984), were analyzed. In the United States, age-adjusted relative odds of incident hypertension between 1971 and 1984 did not vary consistently with region or with urbanization level. There was only a trend of higher relative odds in nonmetropolitan areas than in suburbs in the southeast in younger white men and older white women. Thus, convincing evidence to support the hypothesis of elevated hypertension incidence in the southeast region or in nonmetropolitan areas was not obtained. Further studies of region and hypertension incidence are needed to assess regional variation in larger, more recent cohorts.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640665PMC
May 2004

Bone mineral density and mortality in women and men: the NHANES I epidemiologic follow-up study.

Ann Epidemiol 2003 Nov;13(10):692-7

Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.

Purpose: We sought to assess the long-term association of bone mineral density with total, cardiovascular, and non-cardiovascular mortality.

Methods: The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of non-institutionalized civilians. A cohort aged 45 through 74 years at baseline (1971-1975) was observed through 1992. Subjects were followed for a maximum of 22 years. Included in the analyses were 3501 white and black subjects. Death certificates were used to identify a total of 1530 deaths.

Results: Results were evaluated to determine the relative risk for death per 1 SD lower bone mineral density, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. Bone mineral density showed a significant inverse relationship to mortality in white men and blacks, but did not reach significance in white women. Based on 1 SD lower bone mineral density, the relative risk for white men was 1.16 (95% confidence interval (CI), 1.07-1.26, p<.01), while for white women the relative risk was 1.10 (95% CI, 0.99-1.23, p=.07), and in blacks the relative risk was 1.22 (95% CI, 1.05-1.42, p<.01). Bone mineral density was also associated with non-cardiovascular mortality in all three race-gender groups. An association between bone mineral density and cardiovascular mortality was found only in white men.

Conclusions: Bone mineral density is a significant predictor of death from all causes (white men, blacks), cardiovascular (white men only) and other causes combined, in whites and blacks.
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http://dx.doi.org/10.1016/s1047-2797(03)00062-0DOI Listing
November 2003

United States Census 2000 population with bridged race categories.

Vital Health Stat 2 2003 Sep(135):1-55

Objectives: The objectives of this report are to document the methods developed at the National Center for Health Statistics (NCHS) to bridge the Census 2000 multiple-race resident population to single-race categories and to describe the resulting bridged race resident population estimates.

Method: Data from the pooled 1997-2000 National Health Interview Surveys (NHIS) were used to develop models for bridging the Census 2000 multiple-race population to single-race categories. The bridging models included demographic and contextual covariates, some at the person-level and some at the county-level. Allocation probabilities were obtained from the regression models and applied to the Census Bureau's April 1, 2000, Modified Race Data Summary File population counts to assign multiple-race persons to single-race categories.

Results: Bridging has the most impact on the American Indian and Alaska Native (AIAN) and Asian or Pacific Islander (API) populations, a small impact on the Black population and a negligible impact on the White population. For the United States as a whole, the AIAN, API, Black, and White bridged population counts are 12.0, 5.0, 2.5, and 0.5 percent higher than the corresponding Census 2000 single-race counts. At the sub-national level, there is considerably more variation than observed at the national level. The bridged single-race population counts have been used to calculate birth and death rates produced by NCHS for 2000 and 2001 and to revise previously published rates for the 1990s, 2000, and 2001. The bridging methodology will be used to bridge postcensal population estimates for later years. The bridged population counts presented here and in subsequent years may be updated as additional data become available for use in the bridging process.
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September 2003

Bone mineral density and stroke.

Stroke 2003 May 27;34(5):e20-2. Epub 2003 Mar 27.

Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782, USA.

Background And Purpose: We sought to assess the long-term predictive usefulness of bone mineral density (BMD) for stroke incidence and stroke mortality.

Methods: The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort of 3402 white and black subjects 45 through 74 years of age at baseline (1971 to 1975) was observed through 1992. Hospital records and death certificates were used to identify a total of 416 new stroke cases.

Results: Results were evaluated to determine the relative risk (RR) for stroke per 1-SD decrease in BMD, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. In Cox proportional-hazards analyses, incidence of stroke was not associated with a decrease in BMD in any of the 3 race-sex groups: white men (RR, 1.01; 95% CI, 0.86 to 1.19; P=0.88), white women (RR, 1.13; 95% CI, 0.93 to 1.38; P=0.21), or blacks (RR, 0.93; 95% CI, 0.72 to 1.21; P=0.60). No association between BMD and stroke mortality was found (RR, 1.03; 95% CI, 0.86 to 1.23; P=0.77).

Conclusions: In a large national study, no significant associations of BMD and stroke incidence or mortality were found for whites or blacks.
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http://dx.doi.org/10.1161/01.STR.0000065826.23815.A5DOI Listing
May 2003

The correspondence between interracial births and multiple-race reporting.

Am J Public Health 2002 Dec;92(12):1976-81

Office of Analysis, Epidemiology, and Health Promotion, National Center for Health Statistics, Hyattsville, Md 20782, USA.

Objectives: Race-specific health statistics are routinely reported in scientific publications; most describe health disparities across groups. Census 2000 showed that 2.4% of the US population identifies with more than 1 race group. We examined the hypothesis that multiple-race reporting is associated with interracial births by comparing parental race reported on birth certificates with reported race in a national health survey.

Methods: US natality data from 1968 through 1998 and National Health Interview Survey data from 1990 through 1998 were compared, by year of birth.

Results: Overall multiple-race survey responses correspond to expectations from interracial births. However, there are discrepancies for specific multiple-race combinations.

Conclusions: Projected estimates of the multiple-race population can be only partially informed by vital records.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447362PMC
http://dx.doi.org/10.2105/ajph.92.12.1976DOI Listing
December 2002