Impact of dizziness and obesity on the prevalence of falls and fall-related injuries

Quantify the relationships between dizziness, falls, and obesity among adults.Cross-sectional analysis of a national health survey.Adult respondents in the 2008 National Health Interview Survey balance module were analyzed. With demographic information, data for balance and dizziness problems, reported falls, injuries from falls, and body mass index were extracted. Associations between balance/dizziness problems and falls or injuries from falls were determined. The additional association between obesity and falls or fall-related injuries in the setting of a balance/dizziness problem was determined.Among 216.8 ± 3.5 million adult Americans, 24.2 ± 0.7 million reported dizziness in the past 12 months (11.1% ± 0.3%; mean age, 45.9 ± 0.2 years; 51.7% ± 0.5% female), 11.5% ± 0.3% had fallen in the prior 12 months, and 26.3% ± 0.4% were obese. Among individuals reporting dizziness, 34.3% ± 1.3% reported falls, whereas only 9.1% ± 0.3% of nondizzy individuals reported a fall (odds ratio [OR]: 5.1; P < .001). Among dizzy individuals who reported a fall, 45.8% ± 2.1% were injured by the fall versus 35.6% ± 1.4% nondizzy individuals who fell (OR: 1.5; P < .001). The addition of obesity to dizziness increased the odds of falling by 1.3 (95% confidence interval: 1.2-1.5; P < .001) but did not significantly increase the odds of fall-related injury (P = .110).Dizziness/balance problems are strongly associated with both an increased tendency to fall and increased injury rate from falls among adults. The addition of obesity to dizziness was associated with a higher rate of falling but was not associated with a significantly higher rate of fall-related injury. Balance problems in conjunction with obesity need to be targeted in fall-prevention efforts.2b

Telephone Service Interruption Weighting Adjustments for State Health Insurance Surveys

Many states rely on telephone surveys to produce estimates of uninsurance. To the extent that people in households without telephones differ from those living in households with telephones, estimates will be biased due to lack of coverage of those in households without telephones. We find the disparity in estimates of uninsurance in the Current Population Survey (all people vs. those living in households without telephones) shows a similar association to the disparity found in the state surveys (all people vs. those living in households with telephone service interruptions). We adjust the state survey weights of those people living in households that experienced telephone interruptions to account for people living in households without telephones and evaluate whether the weighting adjustment for telephone service interruptions is advisable

Meeting the Need for State-Level Estimates of Health Insurance Coverage: Use of State and Federal Survey Data

OBJECTIVE: Critically review estimates of health insurance coverage available from different sources, including the federal government, state survey initiatives, and foundation-sponsored surveys for use in state policy research. STUDY SETTING AND DESIGN: We review the surveys in an attempt to flesh out the current weaknesses of survey data for state policy uses. The main data sources assessed in this analysis are federal government surveys (such as the Current Population Survey's Annual Social and Economic Supplement, and the National Health Interview Survey), foundation-supported surveys (National Survey of America's Families, and the Community Tracking Survey), and state-sponsored surveys. PRINCIPAL FINDINGS: Despite information on estimates of health insurance coverage from six federal surveys, states find the data lacking for state policy purposes. We document the need for state representative data on the uninsured and the recent history of state data collection efforts spurred in part by the Health Resources Services Administration State Planning Grant program. We assess the state estimates of uninsurance from the Current Population Survey and make recommendations for a new consolidated federal survey with better state representative data. CONCLUSIONS: We think there are several options to consider for coordinating a federal and state data collection strategy to inform state and national policy on coverage and access