Federal health screening set

March 25, 2005

DAWN DE BUSK /Frontiersman reporter

MAT-SU - Some residents of the Mat Su may hear a knock on their door this summer, and discover someone on their doorstep, wanting to ask questions about what they ate for breakfast.

Don't be alarmed.

Beginning June 28, federal health survey personnel will be screening 1,200 households in the Valley through an interview process. The randomly selected households will first receive a postcard through the mail, letting them know to expect a visit from the National Health and Nutrition Examination Survey.

Out of the 1,200 families to be screened, 460 people will be asked to go through a more intensive exam at one of NHANES' mobile units, which will be parked this summer at the Mat-Su Public Health Center in Wasilla.

Those residents, who will be scientifically selected to represent thousands of Americans in their age and ethnic groups, will receive $100 as well as transportation costs for their time.

Parents of the children who are examined will receive an additional $20 for allowing their child to participate in the survey. The child will also be paid $100.

Sound like a fun summer job? Where can a person sign up?

"There's no way you can volunteer for the survey," said George W. Zipf, chief of the operations branch, who discussed what to expect this summer when four tractor-trailers bearing the NHANES logo pull into the Valley and set up shop in mobile medical centers for two months in the parking lot of the Mat-Su Public Health Center.

"There's randomness on all levels," he explained during his presentation at the Mat-Su Borough Assembly Chambers on Tuesday night.

The Mat-Su was selected as one of 15 counties (boroughs) nationwide, where health-related information and statistics will be gathered.

The National Center for Health Statistics, which conducts the survey, is a division within the federal Centers for Disease Control and Prevention.The surveys and exams are done on a yearly basis.

The last time Alaska was selected - randomly, of course - was in 1994, when Anchorage residents were questioned and received physical examinations. All residents - except prison inmates and on-base military personnel and their families - are eligible to be selected, for either the interview process or the exam. However, non-U.S. residents living in the United States may be part of the survey, if selected.

"If you are selected for the exam, you won't be forced to do it. You must agree voluntarily to do it, only if you're comfortable with it," Zipf said. "We are good guests in your community."

Zipf said only 78 percent of people asked to do the exam actually show up at the mobile medical units. The medical statistics gathered will not be directly available to the public, so Mat-Su residents will not be able to gain access to the results or apply for grants based on the results.

However, at a later date, when the information is compiled and computed, those results will be added to the division's Web site. Even the people doing the survey cannot retrieve the results from their computer once they've entered the data, primarily for the purpose of respecting individuals' right to privacy.

"We go through great length, arguably extreme length, to protect the privacy of the participants," Zipf said. "The information is entered into the computer during at-home interviews and cannot be retrieved until the (workers) are on-site at a high-security spot."

However, all participants will receive the results of their examinations.

"We send reports of the findings to participants as well as providing a doctor to explain information," Zipf said.

The time line on getting the information depends on what type of medical information it is. Blood pressure and heart rate results, of course, can be given to participants immediately.

One to two weeks after the exam, any abnormalities would be reported through the mail, and the participant would be given referral phone numbers.

After four weeks, participants would be notified of any sexually transmitted diseases. Final reports would be mailed to the individuals sometime between 12 and 14 weeks after the examinations.

The four roving research centers - each manned with an exam team that includes one physician, two dietary interviewers, two private health interviewers, three health technicians, one phlebotomist, one manager and one coordinator - each have wheelchair lifts to make them accessible to people who are disabled.

Almost every aspect of the exam is repeated three times to make sure data are accurate.

People who are selected to take the exam and agree to it will undergo tests involving some, but not necessarily all, of the following assessments: blood pressure, blood screening, bone density, cardiovascular health, weight and height measurements, oral health status, hearing, balance and tests for diabetes.

The mobile units also contain state-of-the-art retinal imagery to ascertain any damage to the eyes. Again, not all participants will receive every aspect of the exam.

Most of the physical examinations will occur during a three-week period, however, the medical research units will remain until late August so that all participants who were contacted earlier in the summer have a chance to respond.

As a follow-up, some participants may be asked to wear a physical activity monitor for a week, which records the numbers of miles a person walks or runs. The monitor would be returned in the mail; the division will provide the packaging and stamps.

Some participants may have dust samples collected from their homes, particularly their bedrooms. The in-house health interview will take up about an hour of a person's time, Zipf said.

Questions range from "What did you eat today?" to "How healthy do you feel?" The questions cover the topics of nutrition, mental health, risk behaviors, reproductive health and environmental effects.

The survey results provide NCHS with "a snapshot of the nation's health," Zipf said.

Even though the public is not allowed access to information from the survey, the information gathered may help change public policy.

Anomalies within the population, or other interesting statistics, help lawmakers change regulations in order to improve the health of Americans, or avoid unhealthy factors.

For example, more than two decades ago, the national health examinations revealed a high number of people with lead in their blood. After further evaluation, it was discovered the lead came from gasoline, so laws were passed to produce unleaded gasoline.

Another annual survey showed a correlation between lack of folic acid in pregnant women's diets and a high rate of spina bifida. Now doctors are more educated about the importance of folic acid for a fetus' development.

Also, social service agencies provide information on the subject, giving women who are trying to conceive or are already pregnant an option of foods or supplements to take to get enough folic acid.

This summer's survey in the Mat-Su will not use any borough dollars, only federal money, Zipf said. However, there could be an influx of money coming into the community from the survey workers and the mobile medical unit staff members.

"They'll be in your community. They'll be eating at your restaurants. They'll be going to your churches. And in a small community like this, there's a chance you'll meet them. If you talk to them, you'll find out they're nice people," said Jack Powers, NHANES director of advance arrangements.

In 1994, when the division sampled Anchorage, the employees didn't want to go home (to the Lower 48), he said.

The division will hold an open house July 19. The venue will be advertised closer to the date of that open house. The examinations should be wrapped up by Aug. 22.