User Note Healthy People 2020

• Increase the proportion of children and youth aged 17 years and under who have a specific source of ongoing care
• Increase the proportion of adults aged 18 to 64 years who have a specific source of ongoing care
• Increase the proportion of adults aged 65 years and older who have a specific source of ongoing care

To obtain the appropriate sub-sample, analysts should use ARTHGLUPEV or CLIMBACKC in combination with JNTPAINRATE, and the variables for functional limitations in AOCBC-3, the variables for personal-care limitations in AOCBC-4, the variables for serious psychological distress in AOCBC-5, and the employment status indicator, EMPSTAT, for AOCBC-6. ARTHGLUPEV identifies sample adults who have ever been told by a doctor or health professional that they had arthritis/ rheumatoid arthritis/ gout/ lupus/ fibromyalgia and CLIMBACKC identifies persons with chronic back pain. ARTHWEIGHT and ARTHEXERCISE should also be used with BMI.

The numerator should include women who have had a mammogram within the last 2 years. Healthy People 2020 uses the U.S. Preventative Services Task Force (USPSTF) guidelines to measure this objective. Analysts should use this variable in conjunction with the appropriate age group as defined by current guidelines (e.g., age 50 to 74).

The numerator is the number of ESRD patients in the U.S. whose cause of renal failure was due to diabetes. The ESRD population includes dialysis and kidney transplant recipients. The ESRD population is determined by the United States Renal Data System (USRDS); National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK). The IPUMS NHIS provides the denominator.

Analysts should use DIABETICEV in combination with DENTINT. DIABETICEV identifies sample adults or sample children who have ever been diagnosed with diabetes.

The numerator for this variable are women aged 18 years and older who have ever discussed the possibility of getting a genetic test for cancer risk with a Health Care provider, who met the USPSTF criteria, based on first-degree relatives only, for BRCA1/2 genetic counseling referral, and who do not have a personal history of breast or ovarian cancer. The variables above are for breast cancer; equivalent indicators are available for ovarian cancer. See the USPSTF criteria for full guidelines; these guidelines are specific for non-Ashkenazi Jewish women. The NHIS does not ascertain: 1) Ashkenazi Jewish ancestry; 2) cancer history for second-degree relatives; 3) bilateral breast cancer. These criteria for the numerator were exclude from baseline analyses of the numerator.

Appropriate treatments include masking or sound therapy, cognitive therapy, tinnitus retraining therapy, psychiatric treatment, drugs/medications, nutritional supplements, or surgery.

Respondents who tried any treatment are asked about 23 types of treatments, and these are provided as 23 seperate variables which are listed on the variable description for BALTRET. Treatments include physical therapy, certain exercises, avoiding certain foods, taking medicine, surgery, or wearing magnets or wristbands.

For objective HDS-16.2, "Increase the proportion of adults aged 20 years and older who are aware of the early warning symptoms and signs of a heart attack" researchers can use the variables listed above that indicate knowledge about symptoms and signs of a heart attack for the numerator. The number of persons aged 20 years and over is the denominator.

The denominator for this question are children with definite or severe difficulties with emotions, concentration, behavior, or being able to get along with people.

Adults were classified as doing strengthening activities if they did stregthening activities 2 to 28 times per week. For objective PA 2.4, respondents must do at least either moderate activity (150 minutes) or vigorous activity (75 minutes) or a combination of 150 minutes of activity, or strength training 2-28 times per week.

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The denominator for objectives 5.1 and 5.2 should include children or adults who had an episode of asthma or an asthma attack in the past year.

Persons are classified as having education on early signs, symptoms and response to asthma episodes if they responded “yes” to being taught how to respond to an episode of asthma and either how to recognize early signs and symptoms of an asthma episode or how to monitor peak flow.

The denominator should include adults 45 years and over who report having emphysema or chronic bronchitis. The numerator is adults with emphysema or chronic bronchitis who have an activity limitation due to a respiratory problem.

Sufficient sleep is 8 or more hours for persons age 18-21 years and 7 or more hours for those aged 22 years and over.

Persons are considered as using cigarettes if smoked at least 100 cigarettes in their lifetime and now report smoking cigarettes everyday or some days.

The denominator should include adults (aged 18 and over) who are current smokers, or those report currently smoking cigarettes "everyday" or "some days."

The numerator for objective 5.1 should include persons eligible to quit smoking with recent success in smoking cessation, defined as persons who stopped smoking 6 months to 1 year ago. Those eligible to quit smoking are the denominator, defined as persons who have ever smoked 100 cigarettes who reported that they stopped smoking within the past 1 year as well as current (everyday or someday) smokers who initiated smoking 2 or more years ago. Time since initiation is determined by subtracting the age reported for when the respondent first started smoking regularly from the respondent’s current age. If the difference is 2 years or greater these persons are considered to be eligible to be a recent quitter.

Trouble seeing is defined as trouble seeing, even when wearing glasses.