Exploring nonresponse bias in a health survey using neighborhood characteristics.

Objectives: We examined potential nonresponse bias in a large-scale, population-based, random-digit-dialed telephone survey in California and its association with the response rate.

Methods: We used California Health Interview Survey (CHIS) data and US Census data and linked the two data sets at the census tract level. We compared a broad range of neighborhood characteristics of respondents and nonrespondents to CHIS.

Interview language: a proxy measure for acculturation among Asian Americans in a population-based survey.

We examined health status and access to care among Asian Americans by the following acculturation indicators: nativity, percent lifetime in the US, self-rated English proficiency, and interview language, to assess whether any measure better distinguishes acculturation. Data from the 2003 California Health Interview Survey were used to study the sample of 4,170 US-born and foreign-born Asians by acculturation indicators. We performed t-tests to compare differences in demographics, health status and behaviors, and access to care between the foreign-born and US-born Asians, and between various classifications within foreign-born and the US-born Asian group.

Sociodemographic, family, and environmental factors associated with active commuting to school among US adolescents.

Active commuting (non-motorized transport) to school can be an important source of physical activity for children and adolescents. This research examined sociodemographic, family, and environmental characteristics associated with active commuting to or from school among 3,451 US adolescents aged 12-17 years, who responded to the 2005 California Health Interview Survey. Logistic regression results indicated that those more likely to actively commute were males, Latinos, from lower-income families, attending public school, living in urban areas, and living closer to school.

Switching health insurance and its effects on access to physician services.

Background: This study examines the factors associated with discontinuous health insurance coverage without periods of uninsurance during the past year (ie, switching coverage), and whether it has a detrimental effect on basic access to care.

Research Design: We analyze the 2003 California Health Interview Survey samples of adults, ages 19-64 (n = 32,850) and children, ages 0-18 (n = 13,062), using weighted bivariate and multivariate analyses. We stratified the population first by age (modeling adults separately from children) and then by health status (modeling the full population and the population reporting fair or poor health separately).

Uncontrolled asthma means missed work and school, emergency department visits for many Californians.

In 2005, three million Californians reported that they had current asthma. Despite advances in therapy, asthma remains a disease that is not optimally controlled in many Californians. Inadequately controlled asthma can result in missed work and school and emergency department visits.

Are frequent asthma symptoms among low-income individuals related to heavy traffic near homes, vulnerabilities, or both?

Purpose: To investigate whether frequent asthma symptoms (daily/weekly symptoms) can be attributed to traffic-related exposures, poverty, and/or vulnerabilities.

Methods: Annual average daily vehicle traffic density (TD) within 500 feet of 2001 California Health Interview Survey respondents' residential cross streets was calculated. Logistic regression analyses were performed to evaluate the association between annual average TD and frequent asthma symptoms with income as a confounder and a modifier.

Association of insurance coverage with chlamydia screening.

Objectives: To examine the rates of self-reported Chlamydia trachomatis (CT) screening among young women and to examine the independent association of type of insurance and specific health plans with these rates.

Study Design: Cross-sectional analyses of the 2003 California Health Interview Survey data.

Methods: Using bivariate analysis and logistic regression models, we assessed the CT screening rate of 1659 sexually active women age 18-25 years, given various factors including type of health insurance coverage.

Stressful life events and depressive symptoms in a post-war context: which informal support makes a difference?

Gerontological literature utilizes the life stress paradigm to understand the impact of stress on psychological well-being, as well as the protective role that social resources play in buffering those effects; however these relationships are not well understood within various historical and social contexts. Utilizing a sample of 490 community-residing older adults in post-civil war Lebanon, this study investigates the moderating role of various social support factors in the stress-depression relationship. Contrary to expectations, results suggest that older Lebanese are more susceptible to the effects of health-decline and serious accident events than other types of stressors such as losses in the family and financial problems.

Return to work and degree of recovery among injured workers in California's Workers' Compensation system.

Objectives: To determine factors associated with return to work and self-reported degree of recovery among injured workers in California.

Methods: Using logistic regression and survey data from a representative sample of 965 workers injured between April 1 and June 30, 2005, we investigated the impact of the primary treating physician's (PTP) occupational medicine orientation and interpersonal behavior and access to and timeliness of care on return to work and degree of recovery, controlling for worker and injury characteristics.

Results: Some PTP behaviors significantly increased the likelihood of return to work and some degree of recovery, while recommendations for specialty care reduced the likelihood of returning to work or experiencing some degree of recovery.

Selling syringes to injecting drug users: a study of five pharmacies in Hanoi, Vietnam.

Background: HIV continues to spread rapidly throughout Vietnam with injection drug use remaining the main risk factor for infection. The extent of pharmacy-based needle and syringe distribution has not previously been measured in Vietnam; this article reports on a pilot study exploring pharmacy-based harm reduction activities in Vietnam's capital, Hanoi.

Methodology: Five pharmacies located in Dong Da and Thanh Xuan districts in Hanoi, where two peer-based needle and syringe programs (NSPs) also operate, recorded the numbers of syringes sold to injecting drug users (IDUs) over a one-week period.

Characteristics of dentists providing dental care to publicly insured patients.

Objective: This study aims to identify the practice and patient care characteristics of dentists who provide care to publicly insured patients, beyond currently available existing information, which is typically limited to demographics of such dentists.

Methods: A cross-section of dentists in private practices in California was surveyed, with a 46 percent average adjusted response rate. The sample included 3,180 generalists or specialists who provided general care in private practice.

Improving access through health insurance coverage and safety net expansion: a review of the literature.

Proposals to address the needs of uninsured Californians take one of two broadly different emphases: assuring that the uninsured have access to health services by expanding community health centers and clinics; or by extending health insurance coverage to those without it. This policy brief examines literature on the effect of expanding access to safety net health services versus extending health insurance coverage to those who are currently uninsured. Based on this examination of the literature and analysis of the 2005 California Health Interview Survey (CHIS 2005), we conclude that both approaches are necessary to address access problems faced by the uninsured and underserved.

Satisfaction with care and perceptions of quality among injured workers in California's Workers' Compensation system.

Objectives: To examine satisfaction and perceptions of quality among injured workers after the 2004 reforms in California's Workers' Compensation system. Also, to investigate the impact of provider occupational medicine orientation and interpersonal behavior, access, and timeliness of care on injured worker satisfaction and quality, and to identify aspects of provider behavior and access with the potential for improving future satisfaction and quality.

Methods: Ordered logistic regression using survey data from a representative sample of workers injured between April 1 and June 30, 2005.

Access to preventive services for adults of Mexican origin.

Immigrants arrive in the U.S. with better than average health, which declines over time.

Perceptions of diet and physical activity among California Hmong adults and youths.

Introduction: We conducted a qualitative study to inform the design of a proposed community-wide campaign to promote increased physical activity and fruit and vegetable consumption among low-income Hmong families.

Methods: We held eight focus groups with parents of children aged 5 to 14 years and with youths aged 11 to 14 years, interviews with key informants in several Hmong communities, and interviews with professionals who conducted physical activity and nutrition activities in these communities. Sessions were tape-recorded and transcribed.

Expansion of health insurance in California unlikely to act as magnet for undocumented immigration.

Expansion of health care coverage has risen to the top of the legislative agenda in California. One question within the health care reform debate is whether expanding health insurance to all Californians will attract new undocumented immigrants who would come primarily for those benefits. A review of studies on immigration and public benefits suggests that the net attraction of any major expansion of health insurance in California would be minor in comparison to the existing attractions of jobs, family and other factors.

Increasing access to care for cultural and linguistic minorities: ethnicity-specific health care organizations and infrastructure.

Racial and ethnic disparities in health care have been attributed in part to cultural and linguistic dissonance between certain patient populations and the health care system. Yet in the long term, structural solutions for ameliorating health care disparities have not been forthcoming. One strategy for increasing access to care for cultural and linguistic minorities is ethnicity-specific subsystems of care.