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Towards validating use of self reported health (SRH) for community-based studies: Impact of environmental chemicals, sociodemographic variables, depression, and clinical indicators of health and nutrition
Citation:
Gallagher, J., A. Cordner, R. Birch, E. Hudgens, Jeff Inmon, A. Williams, S. Edwards, AND Tim Wade. Towards validating use of self reported health (SRH) for community-based studies: Impact of environmental chemicals, sociodemographic variables, depression, and clinical indicators of health and nutrition. Presented at NC Environmental Justice Summit, October 18 - 19, 2012.
Impact/Purpose:
This research advances cumulative risk assessments by moving beyond associating single chemical exposures and single health outcomes and provides a more comprehensive understanding of the complex relationships between cumulative environmental exposures, clinical indicators, and socioeconomic determinates
Description:
Environmental health impact assessment (HIA) studies, should consider social, behavioral, nutritional, dietary, environmental exposure and health risk factors at both the individual and community levels. Chemicals measured in blood or urine are often evaluated in relation to one health outcome, and studied one chemical at a time. We used US nationally representative data from the 2003-2006 NHANES surveys (adults ages 20-50). We evaluated the percentages (%) of persons who self reported (poor/fair health) in relation to income, education level, race, depression, health behaviors, combined blood chemical scores (BCS) (derived by summing blood levels for benzene, toluene, Pb, Hg and Cd); clinical indicators (e.g. c-reactive protein (CRP) and (HDL), and health risk factors (e.g. high blood pressure (BP), obesity). The % of persons, reporting poor/fair health had moderate/severe depression (42.9 %), high serum glucose (> 200 mg/dL); (41.1 %), < than a HS education (30.6 %), income level below the poverty level (27.8 %), blood Pb levels > 5.0 ug/dL (27.7%), >5 hrs of TV watching (26.3%), elevated BP (21.1 % ), high CRP levels (20.6%) and < moderate physical activity (19.4 %). Using multivariate logit regression analysis, statistically significant odds ratios (OR- 95% CI) for fair/poor health were : low family income 0.80 (0.70-0.92) p< 0.0023), race (Hispanic compared to Whites) 2.23 (1.11-4.47); p<0.05; CRP levels 1.17 (1.03-1.31) p< 0.05; elevated BP (diastolic > 90); 1.04 (1.00-1.08) p <0.05; depression 3.77 ( 2.04-6.99) p <0.0001 and elevated (4th to first quartile) BCS 1.18 (1.06-1.32) p<0.005. This research suggests that self reported health may be a useful proxy to incorporate in community-based (HIA) studies, advances cumulative risk assessments by moving beyond associating single chemical exposures and single health outcomes and provides a more comprehensive understanding of the complex relationships between c