Epidemiology of Visual Impairment: The 1986-2002 NHIS

描述（由申请人提供）：尽管视力障碍（VI）作为一个公共卫生问题的重要性，但关于这种情况对发病率和死亡率的影响的研究相对较少。拟议中的调查小组先前由国家眼科研究所资助，利用1986-1994年国家健康访谈调查（NHIS）的数据来帮助解决这一知识差距。国家卫生系统在1997年进行了广泛的改进和重新设计。国家卫生统计中心（NCHS）向科学界发布了截至2002年的国家卫生统计系统数据集，其中包括195,907名成年人的VI状态信息；2003年的数据最近由NCHS公布，增加了大约73,000名参与者。关于功能状态、吸烟状况等重要风险因素和获得护理的信息是重新设计的NHIS的附加功能。此外，国家卫生统计中心还为前一年调查年份（1986-1996年）的参与者以及重新设计的国家卫生统计中心（1997-2000年）至2002年的参与者建立了与国家死亡指数的定期死亡率联系更新；这个新的链接现在可以通过NCHS研究数据中心提供给调查人员。重新设计的NHIS以及更新的先前NHIS的死亡率联系将使目前的调查团队能够扩大当前应用程序中提出的具体目标的数量，包括结构方程建模分析以及一个网站，以提供NHIS的眼部数据和发现，作为感兴趣的调查人员的独特资源。本研究的目的包括：1)利用结构方程模型，通过对1986-1996年和1997-2000年NHIS参与者的发病率和功能状态的“间接”影响，确定VI与死亡风险的关联程度；(2)估计1986-1996年NHIS的成人参与者到2002年有或没有报告VI和选定眼病的成年人的总体死亡率和原因特异性死亡率；3)在1997-2000年国家健康调查的参与者中，估计到2002年有和没有报告VI的成年人的短期总体死亡率和原因特异性死亡率，并控制以前的国家健康调查中没有的协变量，如吸烟状况；4)使用重新设计的NHIS调查（1997-2003）的数据估计社会人口亚组中报告的VI的患病率和严重程度；5)使用1997-2003年NHIS的数据评估亚组（如年龄组、性别、种族、民族）7年的VI趋势；6)评估有和没有报告VI的NHIS参与者报告的健康和残疾状况；7)评估VI与获得医疗保健（包括眼科保健）之间的关系；8)针对其他有兴趣使用正在进行的NHIS中可用的眼部数据的科学家，制作并维护一个网站。

DESCRIPTION (provided by applicant): Despite the importance of visual impairment (VI) as a public health problem there has been relatively little research on the influence of this condition on morbidity and mortality. The proposed investigative team was previously funded by the National Eye Institute to help, address this knowledge gap using data from the National Health Interview Survey (NHIS) 1986-1994. The NHIS was extensively improved and redesigned in 1997. The National Center for Health Statistics (NCHS) has released to the scientific community NHIS datasets thru 2002 which include information of the VI status of 195,907 adults; 2003 data have recently been released by NCHS adding approximately another 73,000 participants. Information on functional status, important risk factors such as smoking status, and access to care are additional features of the redesigned NHIS. In addition, the NCHS has instituted regular mortality linkage updates with the National Death Index for participants of the previous survey years (1986-1996) as well as for the redesigned NHIS (1997-2000) thru 2002; this new linkage is now available to investigators through the NCHS Research Data Center. The redesigned NHIS along with the updated mortality linkage for the previous NHIS will enable the present investigative team to expand the number of specific aims proposed in the current application to include structural equation modeling analysis as well as a website to provide NHIS ocular data and findings as a unique resource for interested investigators. Our study aims include: 1) Using structural equation modeling, determine the extent to which VI is related to mortality risk thru its "indirect" effect on morbidity and functional status among participants of the 1986-1996 and 1997-2000 NHIS's; 2) Estimate among adult participants of the 1986-1996 NHIS the overall and cause-specific mortality rates thru 2002 for adults with and without reported VI and selected eye diseases; 3) Estimate among participants of the 1997-2000 NHIS the short-term overall and cause-specific mortality rates thru 2002 for adults with and without reported VI additionally controlling for covariates not available in previous NHIS surveys such as smoking status; 4) Estimate the prevalence and severity of reported VI in sociodemographic subgroups using data from the redesigned NHIS survey (1997-2003); 5) Evaluate 7-year trends in VI in sub-groups (e.g., age-groups, gender, race, ethnicity) using data from the 1997-2003 NHIS's; 6) Evaluate the reported health and disability status of NHIS participants with and without reported VI; 7) Evaluate the association between VI and access to health care, including ophthalmic care; and 8) Produce and maintain a website directed at other scientists interested in using the ocular data available in the ongoing NHIS.