Papers by James Dahlhamer
Health Care Utilization Among U.S. Adults With Inflammatory Bowel Disease, 2015-2016
PubMed, Feb 1, 2021
Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) a... more Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) and compare with adults without IBD. Methods-Adults aged 18 and over with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). This study presents age-adjusted percentages and model-adjusted prevalence ratios (APRs) of selected health service use to identify differences by IBD status. IBD status and use of health care services are based on self-reports. Results-Compared with adults without IBD, adults with IBD were more likely to have visited any doctor or mental health provider in the past 12 months. IBD was also associated with higher prevalence of being prescribed medication, and having received acute care services, such as emergency room visits, overnight hospitalizations, or surgeries. Differences by IBD status were greatest for visiting a specialist (APR: 1.98; 95% confidence interval [CI]: 1.82-2.14) and home visits (APR: 1.80; 95% CI: 1.25-2.59) in the past 12 months. Conclusions-Adults with IBD had higher health service use than adults without IBD. Future studies may assess patient characteristics and outcomes associated with increased utilization among IBD patients.
Using Field Tests to Evaluate Federal Statistical Survey Questionnaires
Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) a... more Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) and compare with adults without IBD. Methods-Adults aged 18 and over with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). This study presents age-adjusted percentages and model-adjusted prevalence ratios (APRs) of selected health service use to identify differences by IBD status. IBD status and use of health care services are based on self-reports. Results-Compared with adults without IBD, adults with IBD were more likely to have visited any doctor or mental health provider in the past 12 months. IBD was also associated with higher prevalence of being prescribed medication, and having received acute care services, such as emergency room visits, overnight hospitalizations, or surgeries. Differences by IBD status were greatest for visiting a specialist (APR: 1.98; 95% confidence interval [CI]: 1.82-2.14) and home visits (APR: 1.80; 95% CI: 1.25-2.59) in the past 12 months. Conclusions-Adults with IBD had higher health service use than adults without IBD. Future studies may assess patient characteristics and outcomes associated with increased utilization among IBD patients.
Sexual orientation in the 2013 national health interview survey: a quality assessment
PubMed, Dec 1, 2014
Objective-This report presents a set of quality analyses of sexual orientation data collected in ... more Objective-This report presents a set of quality analyses of sexual orientation data collected in the 2013 National Health Interview Survey (NHIS). NHIS sexual orientation estimates are compared with those from the National Survey of Family Growth (NSFG) and the National Health and Nutrition Examination Survey (NHANES). Selected health outcomes by sexual orientation are compared between NHIS and NSFG. Assessments of item nonresponse, item response times, and responses to follow-up questions to the sexual orientation question are also presented. Methods-NHIS is a multipurpose health survey conducted continuously throughout the year by the Centers for Disease Control and Prevention's National Center for Health Statistics. Analyses in this report were based on NHIS data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Data from the 2006-2010 NSFG and 2009-2012 NHANES were used for the comparisons. Results-Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay/lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to answer. Responses to follow-up questions suggest that the sexual orientation question is producing little classification error. In addition, largely similar patterns of association between sexual orientation and health were observed for NHIS and NSFG. Analyses of item nonresponse rates revealed few data quality issues, although item response times suggest possible shortcutting of the question and comprehension problems for select respondents.
LGBT health, Apr 1, 2017
Purpose: The purpose of this study was to compare the prevalence and odds of participation in onl... more Purpose: The purpose of this study was to compare the prevalence and odds of participation in online health-related activities among lesbian, gay, and bisexual adults and straight adults aged 18-64. Methods: Primary data collected in the 2013 and 2014 National Health Interview Survey, a nationally representative household health survey, were used to examine associations between sexual orientation and four measures of health information technology (HIT) use. Data were collected through face-to-face interviews (some telephone follow-up) with 54,878 adults aged 18-64. Results: Compared with straight men, both gay and bisexual men had higher odds of using computers to schedule appointments with healthcare providers, and using email to communicate with healthcare providers. Gay men also had significantly higher odds of seeking health information or participating in a health-related chat group on the Internet, and using computers to fill a prescription. No significant associations were observed between sexual orientation and HIT use among women in the multivariate analysis. Conclusions: Gay and bisexual men make greater use of HIT than their straight counterparts. Additional research is needed to determine the causal factors behind these group differences in the use of online healthcare, as well as the health implications for each group.
Sexual orientation and health among U.S. adults: national health interview survey, 2013
PubMed, Jul 15, 2014
Objective: To provide national estimates for indicators of health-related behaviors, health statu... more Objective: To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS). Methods: NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18-64, and separately for men and women. Results: Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18-64 who identified as straight, gay or lesbian, or bisexual. Conclusion: NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual.
Preliminary Evaluation of Nonresponse Bias Due to the COVID-19 Pandemic on National Health Interview Survey Estimates, April-June 2020
Morbidity and Mortality Weekly Report, Feb 16, 2018
Adults with IBD Adults without IBD Estimated no. † Age-adjusted § % (95% CI) Estimated no.
A Review of Potential National Chronic Pain Surveillance Systems in the United States
The Journal of Pain, Sep 1, 2022
Pain has been established as a major public health problem in the United States (U.S.) with 50 mi... more Pain has been established as a major public health problem in the United States (U.S.) with 50 million adults experiencing chronic pain and 20 million afflicted with high-impact chronic pain (i.e., chronic pain that interferes with life or work activities). High financial and social costs are associated with chronic pain. Over the past two decades, pain management has been complicated by the marked increase in opioids prescribed to treat chronic non-cancer pain and by the concurrent opioid crisis. Monitoring the prevalence of chronic pain and pain management is especially important because pain management is changing in uncertain ways. We review potential U.S. chronic pain surveillance systems, present potential difficulties of chronic pain surveillance, and explore how to address chronic pain surveillance in the current opioid era. We consider case definitions, severity, anatomic site, and varieties of chronic pain management strategies in reviewing and evaluating national surveys for chronic pain surveillance. Based on the criteria evaluated, the National Health Interview Survey offers the best single source for pain surveillance as the pain-related questions administered are brief, valid, and cover a broad scope of pain-related phenomenon. Perspective: This review article describes data sources that can be leveraged to conduct national chronic pain surveillance in the United States, explores case defining or pain-related questions administered, and evaluates them against eight surveillance attributes.
American Journal of Public Health, Jun 1, 2016
Objectives. To assess the extent to which lesbian, gay, and bisexual (LGB) adults aged 18 to 64 y... more Objectives. To assess the extent to which lesbian, gay, and bisexual (LGB) adults aged 18 to 64 years experience barriers to health care.Methods. We used 2013 National Health Interview Survey data on 521 gay or lesbian (291 men, 230 women), 215 bisexual (66 men, 149 women), and 25 149 straight (11 525 men, 13 624 women) adults. Five barrier-to-care outcomes were assessed (delayed or did not receive care because of cost, did not receive specific services because of cost, delayed care for noncost reasons, trouble finding a provider, and no usual source of care).Results. Relative to straight adults, gay or lesbian and bisexual adults had higher odds of delaying or not receiving care because of cost. Bisexual adults had higher odds of delaying care for noncost reasons, and gay men had higher odds than straight men of reporting trouble finding a provider. By contrast, gay or lesbian women had lower odds of delaying care for noncost reasons than straight women. Bisexual women had higher odds than gay or lesbian women of reporting 3 of the 5 barriers investigated.Conclusions. Members of sexual minority groups, especially bisexual women, are more likely to encounter barriers to care than their straight counterparts.
Sociological Spectrum, Apr 1, 1998
This research was undertaken with support from the National Center for Earthquake Engineering Res... more This research was undertaken with support from the National Center for Earthquake Engineering Research, Grant No. 93-6303, "Business Disruption and Initial Recovery in the Northridge Earthquake." The ideas and conclusions expressed here are those of the authors; they do not necessarily reflect the views of the National Center for Earthquake Engineering Research.
Natural Hazards Review, May 1, 2000
Morbidity and Mortality Weekly Report, Oct 28, 2016
Objective-This report examines differences in survey reports of disability between two sets of di... more Objective-This report examines differences in survey reports of disability between two sets of disability questions, the Short Set on Functioning (WG-SS) developed by the Washington Group on Disability Statistics (WG) and a set of disability questions developed for the American Community Survey (ACS). Methods-Data from the 2011-2012 National Health Interview Survey were used to examine agreement between the WG-SS and ACS measures. One difference between the question sets is the ACS questions have dichotomous "yes" or "no" responses while the WG-SS questions have four answer categories reflecting a continuum of difficulty. Unweighted prevalence estimates of disability and odds ratios are presented for the subset of respondents who provided self-reports to both sets to understand the level of agreement and investigate differences between the two. Results-Approximately twice as many adults were identified as having disability by the ACS measure compared with the WG-SS measure. This result holds across all subgroups examined. Given the high percentage of respondents reporting no difficulty on both question sets, nonagreement between the two measures is generally low. A variety of sociodemographic and health factors contributed to the observed discordance. While responses of "a lot of difficulty" or "cannot do at all" to the WG-SS questions are highly concordant with "yes" responses to the ACS questions, WG-SS respondents answering "some difficulty" are more likely to have provided "yes" responses to the ACS questions. As a result, the population with disability defined by the ACS questions is more heterogenous in functional level than that defined by the WG-SS questions. Conclusion-The ACS disability measure identifies a higher percentage of respondents with disability than the WG-SS measure, yet overall agreement between the two measures is high. The WG-SS ordinal response categories allow for an examination of disability severity, which is useful in describing the full continuum of functioning.
Environmental Hazards, 2002
Exploring the Associations Between Question Characteristics, Respondent Characteristics, Interviewer Performance Measures, and Survey Data Quality
Innovation in Aging, Dec 1, 2020
final LE prediction equation. In 1,263,595 VA patients, the mean age was 68 years and the majorit... more final LE prediction equation. In 1,263,595 VA patients, the mean age was 68 years and the majority were male (94%) and white (87%). During 12 years of follow-up, 602,576 (47.7%) died. Of 930 predictors from the EHR, 99 were included in the LE prediction equation. Harrell's C-statistic was 0.7705 (95%CI: 0.7693, 0.7718). The model estimated 10-year life expectancy with sensitivity of 81.6% (81.4%, 81.8%) and specificity of 68.8% (68.5%, 69.1%). In conclusion, we developed an LE prediction equation from hundreds of predictors in the VA EHR with good discrimination and calibration that may help clinicians weigh the potential benefit of long-term preventative treatments.
BMC Health Services Research, Jul 29, 2010
Background: We hypothesize that a substantial portion of individuals who forgo conventional care ... more Background: We hypothesize that a substantial portion of individuals who forgo conventional care in a given year turn to some form of alternative medicine. This study also examines whether individuals who use only alternative medicine will differ substantially in health and sociodemographic status from individuals using neither alternative medicine nor conventional care in a given year. To identify those factors that predict alternative medicine use in those not using conventional care, we employed the socio-behavioral model of healthcare utilization. Methods: The current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia. Results: 19.3% of adults (38.3 million) did not use conventional care in a 12 month period, although 39.5% of these individuals (14.7 million) reported having one or more problems with their health. Of those not using conventional care, 24.8% (9.5 million) used alternative medicine. Users of alternative medicine had more health needs and were more likely to delay conventional care because of both cost and non-cost factors compared to those not using alternative medicine. While individual predisposing factors (gender, education) were positively associated with alternative medicine use, enabling factors (poverty status, insurance coverage) were not. Conclusions: We found that a quarter of individuals who forgo conventional care in a given year turn towards alternative medicine. Our study suggests that the potential determinants of using only alternative medicine are multifactorial. Future research is needed to examine the decision process behind an individual's choice to use alternative medicine but not conventional medicine and the clinical outcomes of this choice.
American Journal of Industrial Medicine, Jul 20, 2012
Objective-Assess the national prevalence of current workplace exposure to potential skin hazards,... more Objective-Assess the national prevalence of current workplace exposure to potential skin hazards, secondhand smoke (SHS), and outdoor work among various industry and occupation groups. Also, assess the national prevalence of chronic workplace exposure to vapors, gas, dust, and fumes (VGDF) among these groups. Methods-Data were obtained from the 2010 National Health Interview Survey (NHIS). NHIS is a multistage probability sample survey of the civilian non-institutionalized population of the US. Prevalence rates and their variances were calculated using SUDAAN to account for the complex NHIS sample design. Results-The data for 2010 were available for 17,524 adults who worked in the 12 months that preceded interview. The highest prevalence rates of hazardous workplace exposures were typically in agriculture, mining, and construction. The prevalence rate of frequent handling of or skin contact with chemicals, and of non-smokers frequently exposed to SHS at work was highest in mining and construction. Outdoor work was most common in agriculture (85%), construction (73%), and mining (65%). Finally, frequent occupational exposure to VGDF was most common among mining (67%), agriculture (53%), and construction workers (51%).
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Papers by James Dahlhamer