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Healthy People 2010 – Women's and Men's Health: A Comparison of Select Indicators

Technical Appendix

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Data Sources

This report examines progress by women and men toward 18 Healthy People 2010 objectives. The data used to assess progress were obtained from several published reports and public-access data systems. These data were originally collected through a number of national surveys and surveillance systems. Table A-1 lists the data systems and sources for each objective.

Table A-1: Data Sources for Each Objective

Healthy People 2010 Objective	Data System	Sources for Data Used in This Report
1-1. Persons with health insurance; under age 65 years	National Health Interview Survey (NHIS)	Trends: DATA2010 (data years 1997 — 2006); Health United States, 2007. Select Populations: Health Data for All Ages.
1-4c. Persons with a source of ongoing care; 18+ years	NHIS	Trends: DATA2010 (data years 1997 — 2006). Select Populations: Health Data for All Ages (inverse of data tabulated).
3-13. Mammogram within past 2 years; women 40+ years	NHIS	Trends and Select Populations: DATA2010 (data years 1998 — 2005) and Health United States, 2007 (data years 1990 — 1995).
13-6. Condom use at last intercourse; unmarried, sexually active persons aged 18 to 44 years	National Survey of Family Growth	Trends and Select Populations: DATA2010.
14-29a. Influenza vaccination within past year; 65+ years 14-29b. Pneumococcal vaccination ever received; 65+ years	NHIS	Trends: DATA2010 (data years 1998 — 2006). Select Populations: Not available.
15-34. Physical assaults by intimate partners; 12+ years	National Crime Victimization Survey	Trends: DATA2010 (data years 1998 — 2005) and a special data table prepared by Bureau of Justice Statistics (BJS) using the Healthy People 2010 definition of intimate partner assault to produce statistics for 1992 — 1997. Select Populations: Not available.
16-6a. Prenatal care beginning in the first trimester	National Vital Statistics System — Natality	Trends: DATA2010 (data years 1998 — 2005) and Health United States, 2007 (data years 1990 — 1997). Select Populations: DATA2010.
18-9b. Persons with depression who received treatment; 18+ years	National Comorbidity Survey — Replication	Trends: DATA2010. Select Populations: Not available.
19-2. Obesity; 20+ years	National Health and Nutrition Examination Survey (NHANES)	Trends: _DATA2010 (data years 1988 — 94 through 2003 — 2006). Select Populations: Health Data for All Ages. (data years 2003 — 2006).
22-2. Persons engaging in regular exercise; 18+ years	NHIS	Trends: DATA2010 (data years 1997 — 2006). Select Populations: Health Data for All Ages.
25-11a. Never had sexual intercourse; students in grades 9 — 12 25-11b. If sexually experienced, not currently sexually active; grades 9 — 12 25-11c. If currently sexually active, used a condom at last intercourse; grades 9 through 12	Youth Risk Behavior Surveillance System (YRBSS)	Trends: DATA2010 (data years 1999 — 2005); and YRBSS Youth Online (data years 1991 — 1997, 2007). Select Populations: YRBSS Youth Online.
26-10a. Persons not using alcohol or illicit drugs in past 30 days; 12 — 17 years. 26-10c. Persons using illicit drugs in past 30 days; 18+ years 26-11c. Binge drinking in past 30 days; 18+ years	National Survey on Drug Use and Health	Trends: DATA2010 (data years 2002 — 2006) Select Populations: Not available.
27-1a. Cigarette smoking; 18+ years	NHIS	Trends: DATA2010 (data years 1997 — 2006); and Health United States, 2007 (data years 1990 — 1997). Select Populations: Health Data for All Ages.

A brief description follows of each of the national surveys that collected the underlying data.

National Comorbidity Survey — Replication (NCS-R). The 2002 NCS-R was a follow-up to the 1990 National Comorbidity Survey (NCS), a nationally representative mental health survey which used a structured diagnostic research interview to study the prevalence and correlates of a variety of mental health disorders. The NCS-R interviewed 10,000 new respondents to study trends for variables assessed in the original NCS and to examine new areas.¹ A description of the NCS-R is available at www.hcp.med.harvard.edu/ncs.

National Crime Victimization Survey (NCVS). NCVS is a cross-sectional household interview survey of the civilian noninstitutionalized population. The survey is conducted annually by the U.S. Department of Justice, Bureau of Justice Statistics (BJS), to examine the frequency, characteristics, and consequences of criminal victimization in the United States. Data are collected from approximately 77,000 households, including about 134,000 persons aged 12 years and older.² More information about the survey is available at www.ojp.usdoj.gov/bjs/cvict.htm.

National Health and Nutrition Examination Survey (NHANES). NHANES is a national survey designed to collect information on the health and nutritional status of the civilian noninstitutionalized population through in-home interviews and physical examinations. Since 1999, the survey has been conducted continuously by the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS). The health examination is conducted in mobile examination centers where many tests are performed. Approximately 5,000 persons are examined at 15 locations around the United States each year. Data are aggregated over 2-, 4-, or 6-year clusters to achieve needed sample size.³ A more complete description of NHANES is available at www.cdc.gov/nchs/nhanes.htm.

National Health Interview Survey (NHIS). NHIS is a cross-sectional household interview survey of the civilian noninstitutionalized population conducted by CDC, NCHS. The survey has been fielded annually since 1957 and covers a broad range of health topics. The current anticipated sample size (completed interviews) includes approximately 35,000 households containing about 87,500 persons.⁴

The NHIS questionnaire was redesigned and the survey administered using computer-assisted personal interviews (CAPI) in 1997.⁴ Consequently, data for years prior to 1997 may not be strictly comparable to data for later years. More information about NHIS and the 1997 redesign is available at www.cdc.gov/nchs/about/major/nhis/hisdesc.htm.

National Survey on Drug Use and Health (NSDUH). NSDUH is a cross-sectional household interview survey of the civilian noninstitutionalized population conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey oversamples persons aged 12 to 25 years. In 2004, 130,000 households were screened, and 67,000 completed interviews were obtained.⁵

NSDUH, formerly called the National Household Survey on Drug Abuse (NHSDA), was redesigned between 1999 and 2002 and renamed NSDUH. As a result of the methodological changes adopted in 2002, data for years prior to 2002 are not comparable to more recent data and hence are not shown in this report. A complete description of NSDUH is available at www.oas.samhsa.gov/nhsda.htm.

National Survey of Family Growth (NSFG). NSFG is a cross-sectional household interview survey of the civilian noninstitutionalized population aged 15 to 44 years conducted by CDC, NCHS. Before 2006, the survey was conducted periodically. The 1995 survey focused on women only. The 2002 survey included both male and female respondents. Interviews were completed with approximately 12,500 persons in 2002.⁵ A complete description of the survey is available at www.cdc.gov/nchs/nsfg.htm.

National Vital Statistics System — Natality (NVSS-N). Data in the NVSS-N are based on 100 percent of the birth certificates filed in all States and the District of Columbia (approximately 4.1 million in 2005).⁶ More information about the NVSS-N is available at www.cdc.gov/nchs/nvss.htm.

Youth Risk Behavior Surveillance System (YRBSS). YRBSS is a school-based survey administered in classrooms by professional survey administrators. The survey, sponsored by CDC, National Center for Chronic Disease Prevention and Health Promotion, is conducted by using anonymous self-administered questionnaires. The national survey is completed biennially by students in grades 9 through 12 attending about 150 public and private schools. Black and Hispanic students are sampled at a higher rate. In 2007, more than 14,000 students in 157 schools completed the national survey.⁷ A description of the YRBSS is available at www.cdc.gov/healthyyouth/yrbs.

As shown in table A-1, almost all of the data cited in this report were obtained from previously published reports and public access data systems, including the following:

DATA2010. DATA2010 is an interactive, online database developed by CDC, NCHS. It contains the national baseline and tracking data for all measurable Healthy People 2010 objectives. State data are available for a subset of the measurable objectives. For population-based objectives, data are shown by race and Hispanic origin, gender, and socioeconomic status (education or income).⁵ DATA2010 can be accessed through NCHS's Healthy People 2010 website at www.cdc.gov/nchs/hphome.htm.

Health Data for All Ages (HDAA). HDAA is an interactive database that provides tabulations from CDC data sources on the health of all Americans by select characteristics. Data are aggregated over 3- or 4-year periods. HDAA can be accessed through www.cdc.gov/nchs/datawh/datatools.htm.

YRBSS Youth Online. YRBSS Youth Online is an interactive online system that allows the user to produce tabulations of data from the YRBSS. Data are available for the period 1991 to 2005. YRBSS Youth Online can be accessed through www.cdc.gov/healthyyouth/yrbs.

Additional data were obtained from Health United States, 2007.³ Tabulations from the statistical spreadsheets on the companion CD-ROM were also used in this report.

For one objective (15-34, Physical Assaults by Intimate Partners), data for years prior to the Healthy People 2010 baseline were obtained from a special tabulation prepared by BJS. These data, which were tabulated using the Healthy People 2010 definition for the objective, are presented in table A-2.

Table A-2. Physical Assaults by Intimate Partners on Persons Aged 12 Years and Older (Rate per 1,000 Population)

Year	Female	Male
1992	8.8	1.4
1993	7.9	1.6
1994	7.5	0.9
1995	6.8	1.3
1996	6.7	1.0
1997	7.2	1.3

Source: U.S. Department of Justice, Bureau of Justice Statistics, National Crime Victimization Survey. (Special tabulation prepared by the Bureau of Justice Statistics.)

Trend Data and Data for Select Populations

This report examines two types of data for each of the Healthy People 2010 objectives under consideration. Trend data for total females and males covering all available years between 1990 and 2006 are analyzed. In addition, when tabulated data are available, data for gender-specific populations groups are examined. Select populations groups are categorized by race and ethnicity, age, income, education, and geographic location (urban/rural). Because tabulated trend data for select population groups often are not available in the sources used for this report, analyses presented in this report are limited to an examination of the most recent reliable data points.

Age Adjustment

Because outcomes may vary by age, data for a number of the measures examined in this report are age adjusted. Age adjustment is a technique to control for differences among populations or changes over time due only to differences in age composition. Additional information on age adjustment and its use in tracking Healthy People 2010 objectives has been published.⁵

All age-adjusted rates in this report are based on the year 2000 standard population, which was derived from the projected U.S. population in 2000.^8,9 The age groups used to adjust each objective depend on the data source and the population targeted by the objective.¹⁰ For four objectives (Source of Care, Obesity, Exercise, and Smoking), the age groups used to adjust the trend data differ from those used to adjust the data for select populations. This difference occurs because the trend data and select population data for these objectives were obtained from different published sources (see table A-1). In these instances, the trend data are not strictly comparable to the data for select populations; however, the differences are minimal.

Age-adjusted data obtained from HDAA are adjusted by using the following age groups: 18 to 44, 45 to 64, and 65 years and older. Age groups used to adjust data from other sources are included with the definition for the relevant objective (see below).

Confidence Intervals

When available in the published sources used for this report, 95 percent confidence intervals are shown on charts and graphs. (Confidence intervals were not calculated directly; rather, those published in the data sources were used.) Unless otherwise specified, differences reported in the text are statistically significant at the 95 percent level. Statistical testing was accomplished either by a 2-tailed t-test, using p <0.05, or by examination of 95 percent confidence intervals, with significance indicated by nonoverlapping intervals. In the latter case, results are usually more conservative than when a t-test is used.

Definitions

Race and ethnicity. The categories for race and ethnicity used in this report conform to the Federal Standards for reporting race and ethnicity data. The original Standards, published in 1978, called for Federal data systems to classify individuals into the following four racial groups: American Indian or Alaska Native, Asian or Pacific Islander, black, and white.¹¹ In 1997, revisions to the classification system were announced.¹²

Surveys generally ask two questions. The first question asks whether the respondent considers himself/herself to be of Hispanic or Latino origin. The second question asks respondents to self-identify with one or more of the following racial groups:

• American Indian or Alaska Native
• Asian
• Black or African American
• Native Hawaiian or Other Pacific Islander
• White

Additional, more detailed racial and Hispanic origin groups may be included in the response categories to these questions. The responses are grouped into the following categories for analytical purposes: American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, two or more races, Hispanic, black non-Hispanic, and white non-Hispanic. Persons are classified as Hispanic if they responded "yes" to the first question, regardless of their response to the second question. Persons are classified as black non-Hispanic if they responded "no" to the first question and "black or African American" was their only response to the second question. Similarly, persons are classified as white non-Hispanic if they responded "no" to the first question and "white" was their only response to the second question. Persons who responded "no" to the first question and gave more than one response to the second question are classified as being of two or more races.⁵

Beginning with data year 1999, the NHANES, NHIS, and NSFG data for race and ethnicity cited in this report were collected using the 1997 Standards. Prior to that year, the 1977 Standards were used.³ Data on Hispanic origin were collected as a separate question in these surveys and are available for the entire period under consideration in this report.

Prior to 1999, the YRBSS used a single question to obtain data on race and ethnicity. Respondents could select only one of the following categories: white (not Hispanic), black (not Hispanic), Hispanic or Latino, Asian or Pacific Islander, American Indian or Alaska Native, or other. Beginning in 1999, the 1997 Standards were implemented, and students were given the option of selecting more than one category to describe their race and ethnicity. Between 1999 and 2003, a single question was used to collect race and ethnicity. The separate Hispanic question was added to the YRBSS beginning with data year 2005.

Although YRBSS data are collected for five to six racial/ethnic categories, the YRBSS publishes race and ethnicity data using only four groupings: white, black, Hispanic, and other. The "other" category combines all responses except the other three mentioned above.⁷ Data for the "other" category are excluded from this report. Because the definitions of "white" and "black" used in the YRBSS conform to the definitions of "white non-Hispanic" and "black non-Hispanic" used in other data systems, the race and ethnicity categories for YRBSS data cited in this report are labeled as "other," Hispanic, black non-Hispanic, and white non-Hispanic.

For the objective on Prenatal Care, responses of "Asian" or "Native Hawaiian or Other Pacific Islander" were combined into one category — "Asian or Pacific Islander," for mother's race. In addition, the category "two or more races" was not available. This reflects the availability of particular data items in various State systems that supply data to the NVSS-N. A detailed description of the issue has been published.⁶

Income Family income data are grouped into three categories: poor, near poor, and middle/high. Poor is defined as a family income below the Federal poverty level. Near poor is defined as a family income between 100 percent and 199 percent of the poverty level, while middle/high (called nonpoor in the HDAA) is a family income of at least 200 percent of the poverty level.⁵

Urban/rural. The designation of a place of residence as metropolitan (urban) or nonmetropolitan (rural) depends on whether the household resides within a metropolitan statistical area (MSA). Omb defines MSA according to published standards that are applied to data from the U.S. Bureau of the Census. A metropolitan area is defined as a core area containing a large population nucleus together with adjacent communities having a high degree of economic and social integration with that core. All communities within a metropolitan area are classified as metropolitan (or urban). Communities not within a metropolitan area are considered nonmetropolitan (or rural).¹³

Education. Education data are available for three of the variables studied in this report: mammograms, prenatal care, and adult condom use. In general, education level is only tabulated for persons above a specific age threshold. For adult condom use, education data are presented for persons aged 25 years and older. For prenatal care, the minimum age for presenting education data is 20 years. The third variable, mammograms among women aged 40 years and older, presents education data for the entire population under consideration.

Explanatory Notes and Definitions for Each Objective and Subobjective

Education data are grouped into three categories: less than high school, high school graduate, and at least some college. The questions used to obtain these data vary by survey. Data for the mammogram and condom use objectives are obtained from the question "What is the highest level of school X has completed or the highest degree obtained?" Data for the prenatal care objective are based on number of years of school completed, with 12 being equivalent to a "high school graduate."³

1-1. Persons With Health Insurance. Health insurance coverage is defined as having any type of health insurance or health care plan. Respondents were asked a series of questions regarding their health insurance coverage at the time of the interview. Persons are identified as insured if they report having any private health insurance, Medicare, Medicaid, State Children's Health Insurance Program (SCHIP), State-sponsored or other Government-sponsored health plan, or military plan at the time of the interview. A person was defined as uninsured if he or she reported having only Indian Health Service coverage, or only a private plan that paid for one type of service such as accidents or dental care.³

The questions used by NHIS to determine health insurance coverage changed over the course of the survey. More information on changes in the questions and the definition of health insurance coverage is available in appendix II of Health United States, 2007.³

The health insurance data published in Health United States, 2007 and HDAA show percentages of persons without insurance coverage. Therefore, to construct measures for this report, the data in these sources were subtracted from 100 percent to obtain the percentages of persons with health insurance.

1-4c. Persons With a Source of Ongoing Care. Persons are considered to have a source of ongoing care if they receive their health care from a doctor's office, clinic, health center facility, urgent care/walk-in clinic, hospital outpatient clinic, HMO (health maintenance organization/prepaid group), military or other VA health care, or some other place. Persons who report the emergency department as the place of their usual care are defined as having no source of ongoing care.⁵

Trend data for the total male and female populations are age adjusted to the 2000 standard population by using the following five age groups: 18 — 24, 25 — 34, 35 — 44, 45 — 64, and 65 years and older.

The source of care data published in HDAA show percentages of persons without a source of ongoing care. Therefore, to construct measures for this report, the HDAA data were subtracted from 100 percent to obtain the percentages of persons with a source of care.

3-13. Mammograms. Mammography is an x-ray image of the breast used to detect irregularities in breast tissue. The questions on NHIS designed to produce the estimates of mammography use were revised in the 1999, 2000, and 2005 questionnaires. In 1999, 2000, and 2003, women who responded that their most recent mammogram was "2 years ago" were considered to have received the screening within the recommended 2-year interval. In 2005, women who responded similarly were further asked whether the mammogram was "more than 1 year but not more than 2 years ago" or "more than 2 years ago." Thus, estimates for 2005 are more precise compared with 1999, 2000, and 2003 and are slightly lower than they would be without this additional information.³

Mammography data are age adjusted to the 2000 standard population by using four age groups: 40 — 49, 50 — 64, 65 — 74, and 75 years and older.

13-6. Condom Use at Last Intercourse. Objective 13-6 has two subobjectives: 13-6a, Tracking Women, and 13-6b, Tracking Men. Because separate subobjectives exist for women and men, the female and male targets were established separately and are different. There are currently two data points for women (1995 and 2002) and one for men (2002). The definition has several parts:⁵

Marital status. Persons are considered to be unmarried if they reported that they were either not married but living together with a partner of the opposite sex, widowed, divorced, separated, or had never been married.

Sexually active. Persons are considered to be sexually active if they have had sexual intercourse within the 3 months prior to interview.

Used a condom at last intercourse. Women are considered to have used a condom at last intercourse if they reported that either their partner used a condom (rubber) or they used a female condom (vaginal pouch) at last intercourse. Men are considered to have used a condom at last intercourse if they reported that either they used a condom or their partner used a female condom at last intercourse.

14-29a. Influenza Vaccination Within Past Year. These data are age adjusted to the 2000 standard population by using two age groups: 65 — 74 and 75 years and older.

14-29b. Pneumococcal Vaccination Ever Received. These data are age adjusted to the 2000 standard population by using two age groups: 65 — 74 and 75 years and older.

15-34. Physical Assault by Intimate Partners. This objective tracks the rate per 1,000 population of assaults on persons aged 12 years and older by their intimate partners. Violence between intimate partners includes rapes, robberies, and assaults committed by intimates. Intimate relationships involve current or former spouses, boyfriends, or girlfriends, including same sex relationships. This measure does NOT include physical assaults committed by other relatives (parent, child, sibling, grandparent, in-law, cousin), acquaintances (friend, coworker, neighbor, schoolmate, someone known), or strangers (anyone not previously known by the victim). In addition, "series assaults" (that is, repeat victimizations that happened at least six times during the previous 6 months, were similar in nature, and for which the respondent could not remember all the details of each) are excluded.⁵

16-6a. Prenatal Care in the First Trimester. This subobjective tracks the percentage of mothers who received prenatal care in the first trimester of pregnancy. Information on prenatal care is derived from the item on the 1989 revision of U.S. Standard Certificate of Live Birth that asks for the month of pregnancy in which prenatal care began. Women who receive prenatal care in the first 3 months of pregnancy are considered to have begun care in the first trimester. The denominator for this measure is live births. The number of births with missing values is subtracted from the denominator population before the percentage is calculated.¹⁴

Due to comparability issues between the calculation of prenatal care data from the 1989 and 2003 revisions of the standard birth certificate, States that implemented the 2003 revision prior to 2006 are excluded from these data. The 2003 revision is described in detail elsewhere.¹⁵ Two States — Florida and New Hampshire — are excluded from the 2003 data; 9 States — Florida, Idaho, Kentucky, New Hampshire, New York (excluding New York City), Pennsylvania, South Carolina, Tennessee, and Washington — are excluded from 2004; while 12 States (the 9 listed above plus Kansas, Nebraska, Texas, and Vermont) are excluded from the 2005 data.⁶

18-9b. Persons With Recognized Depression Who Receive Treatment. This subobjective tracks persons aged 18 years and older who report symptoms of depression and also report having received help from a mental health professional. The DSM-IVTR criteria are used to establish a diagnosis of a major depressive episode. (The DSM-IVTR is the 2000 revision of the fourth edition of the manual published by the American Psychiatric Association, which addresses diagnostic criteria, descriptions, and other information to guide the classification of mental disorders.¹⁶) "Treatment" is defined as therapeutic intervention and/or the prescription of psychotropic drugs.⁵

19-2. Obesity. This objective tracks the age-adjusted percentage of persons who are determined to be obese. The obesity measure is derived from a person's measured height and weight without shoes. Obesity is defined as a body mass index (BMI) of 30.0 or greater.³ BMI is calculated by dividing weight in kilograms by the square of height in meters. The rationale for selecting a BMI of 30 as the cutoff point for obesity has been published.^17,18

Trend data are age adjusted to the 2000 standard population using seven age groups: 20 — 29, 30 — 39, 40 — 49, 50 — 59, 60 — 69, 70 — 79, and 80 years and older.

22-2. Physical Activity (Exercise). This objective tracks the age-adjusted percentage of persons aged 18 years and older who exercise regularly. Adults are classified as exercising regularly if they engage in light or moderate physical activity five or more times per week for 30 or more minutes for each time or they engage in vigorous physical activity three or more times per week for 20 or more minutes for each time.⁵

Vigorous activities are those causing heavy sweating or large increases in breathing or heart rate. Light or moderate activities are those that cause only light sweating or a slight to moderate increase in breathing or heart rate.

Trend data are age adjusted to the 2000 standard population using five age groups: 18 — 24, 25 — 34, 35 — 44, 45 — 64, and 65 years and older.

NHIS data used to track this measure are restricted to leisure-time physical activity. Therefore, persons whose occupational functions include sustained physical activity may not be classified as participating in regular physical activity if they do not engage in leisure-time physical activity in addition to their occupational activities.

25-11a. Adolescent Sexual Behavior: Never Had Sexual Intercourse. This subobjective tracks the percentage of students in grades 9 through 12 who have never had sexual intercourse.

The data available through YRBSS Youth Online show the percentages of students who have had sexual intercourse. Therefore, to construct measures for this report, these data were subtracted from 100 percent to obtain the percentages of students who had never had intercourse.

25-11b. Adolescent Sexual Behavior: If Sexually Experienced, Not Currently Sexually Active. This subobjective tracks the percentage of students in grades 9 through 12 who are sexually experienced but not currently sexually active. Students meeting the definition for this objective are those who report that they have had sexual intercourse, but not in the in the past 3 months.⁵

The data available through YRBSS Youth Online show percentages of all students who have had sexual intercourse in the past 3 months. Therefore, the following formula was used to construct measures for this variable:

25-11c. Adolescent Sexual Behavior: If Currently Sexually Active, Used a Condom at Last Intercourse. This subobjective tracks the percentage of students in grades 9 through 12 who are currently sexually active and used a condom at their last sexual intercourse. Students meeting the definition for this subobjective are those who report that they have had sexual intercourse within the past 3 months and that the last time they had intercourse, they or their partner used a condom.⁵

26-10a. Adolescents Not Using Alcohol or Illicit Drugs. This subobjective tracks the percentage of persons aged 12 to 17 years who did not use alcohol or illicit drugs in the past 30 days. Illicit drug use is defined as using at least one of the following substances: marijuana or hashish, cocaine (including "crack"), inhalants, hallucinogens (including PCP and LSD), heroin, or any nonmedical use of analgesics, tranquilizers, stimulants, or sedatives. Persons aged 12 to 17 years are considered to have not used alcohol or illicit drugs if they report no use of any of these substances and no alcohol use in the 30 days preceding the interview.⁵

26-10c. Persons Using Illicit Drugs. This subobjective tracks the percentage of persons aged 18 years and older who used illicit drugs in the past 30 days. The definition of illicit drugs is the same as that used for subobjective 26-10a. Persons are considered to have used illicit drugs if they report the use of any of these substances within the 30 days preceding the interview.⁵

26-11c. Binge Drinking. The subobjective tracks the percentage of persons aged 18 years and older who engaged in binge drinking at least once in the past 30 days. Binge drinking is defined as drinking five or more alcoholic beverages at the same time or within a couple of hours of each other.⁵

27-1a. Cigarette Smoking. This subobjective tracks the age-adjusted percentage of persons aged 18 years and older who currently smoke cigarettes. Persons are considered to be current cigarette smokers if they report that they smoked at least 100 cigarettes in their lifetime and now report smoking cigarettes every day or some days.⁵

Trend data for total males and females are age adjusted to the 2000 standard population using five age groups: 18 — 24, 25 — 34, 35 — 44, 45 — 64, and 65 years and older.

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18. National Institutes of Health. (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults — The evidence report. Obesity Research 6(Suppl 2), 51S — 209S. Also available at http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf (PDF, 1.25 MB). [Retrieved May 29, 2009.]

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