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APPENDIX 1 STATISTICAL NOTES HEALTH AND NUTRITION EXAMINATION SURVF.Y The Health and Nutrition Examination Survey (HANES) is a contin- uing nationwide sample survey conducted by the National Center for Health Statistics in which data are collected through standardized physical examinations, tests, and measurements. Information from the examination is supplemented with personal and demographic characteristics and medical history on illnesses, injuries, impairments, chronic condi- tions, utilization of health resources, the need for medical and dental care, and other health topics. From the examination and history data, information is obtained on the total prevalence of selected health conditons, known and previously unknown or undiagnosed. The content of the HANES program is revised periodically and selected components added and deleted to meet current needs for health data of this type. For this survey two to four years are required to obtain a large enough sample of examinees for reliable national estimates. The universe for HANES is the civilian noninstitutionalized population of the United States. Members of the Armed Forces, U.S. nationals living in foreign countries, and people living in institutions during the reference period are excluded. The 1971-1974 HANES program is based on a multistage stratified probability sample of loose clusters of persons in land-based segments in which 65 primary sampling units were selected from the approximately 1,900 geographically defined units into which the United States was divided. Approximately 28,000 persons ages 1-74 years were selected in the sample of whom nearly 21,000 came into the examining location for exami- nation. The initial response rate for the medical history, personal and demographic data was about 95 percent; the final response rate for this examination, about 76 percent. National estimates are based on a four-stage estimation procedure involving inflation by the recipro- cal of the probability of selection of the individual examines, a non- response adjustment, ratio adjustment and postratification. Since the HANES estimates shown in this report are based on a sample of the population, they are subject to sampling error. The standard error of selected percentages of persons needing dental treat- ment is given in Table I. For more detailed information on the HANES design, limitations of the data and sampling errors of the national estimates, see: National Center for Health Statistics, Basic Data on Dental Examination Findings of Persons 1-74 Years, United States, 1971-1974, by James E. Kelly, 1 - 1

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D.D.S., and Clair R. Harvey, Vital and Health Statistics, Series 11-No. 214, DREW Pub. No. (PHS) 79-1662. Public Health Service, Washington, D.C., U.S. Government Printing Office, Nov. 1978. Health Interview Survey The Health Interview Survey (HIS) is a continuing nationwide sample survey conducted by the National Center for Health Statistics in which data are collected through personal household interviews. Information is obtained on personal and demographic characteristics, illnesses, injuries, impairments, chronic conditions, utilization of health resources, and other health topics. The household questionnai is reviewed each year and supplemental topics are added and deleted. For most topics, data are collected over an entire calendar year. The universe for HIS is the civilian, noninstitutionalized population of the United States. Members of the Armed Forces, U.S. nationals living in foreign countries, and people who died during the reference period are excluded. re The survey is based on a multistage probability cluster sample of 376 primary sampling units selected from approximately 1,900 geographi- cally defined units in the first stage and 12,000 segments containing about 42,000 eligible households. National estimates are based on a four-stage estimation procedure involving inflation by the reciprocal of the probability of selection, a non-response adjustment, ratio adjustment, and posts/ratification. Since the HIS estimates shown in this report are based on a sample of the population, they are subject to sampling error. Table II shows the standard errors of aggregates of persons and dental visits, and table III shows standard errors of percentages of persons. For more detailed information on the HIS design, limitations of data, and sampling errors of the estimates, see: National Center for Health Statistics, Current Estimates from the Health Interview Survey, United States, 1977, by L.J. Howie and T.F. Drury, Vital and Health Statistics, Series 10-No. 126, DREW Pub. No. (PHS) 78-1554, Public Health Service, Washington, n.c. , u.s. Government Printing Office, Sep. 1978.

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Table I. STANDARD ERROR FOR PERCENTA(;E: OF PERSONS A(~:D 1-74 TF.ARS WITH NEED FOR DE: NTAL TREATMENT, BY AGE AND TYPE OF SERVICE Specific dental treatment needed Both Sexes General (at least one of the following). Total yrs .. 1.31 1.05 Removal of debris and calculus 2.56 0~61 Gingivitis treatment 1.30 0.01 Periodontal disease treatment 0.42 Severe malocculusion 1-5 6-11 yrs 12-17 18-64 65-74 yrs yrs yrs Standard error - 2~15 1.71 1 2.82 3.55 0.33 1.18 0.02 0.09 ().43 treatment 0.18 0.07 0.89 0.75 Fixed bridges and/or partials... 0.93 - 0.11 1 - 3 1.79 2.02 3.21 3.06 1.90 2.64 0.95 0.92 0.09 - 0.81 1.63 0.97

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Table II. STANDARD ERRORS OF ESTIMATES OF AGGREGATES Standard error in thousands Si ze o f e stimate in thousand s Number o f Population dental visits .. . . . 100. . . 500 ~ . . . l'OOOo.~ee.. 5 ~ 000. . 15 18 40 57 125 10~000~. 174 1 303 677 958 20~000~e 237 1~355 50~000~. 325 2~147 100~000~ee.~e 550 3~047 200 ~ 000 250~000~ee.~e 300~000e 1-4 4~338 4~865 5~346

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Table III. STANDARD ERRORS, EXPRESSED IN PERCENTAGE POINTS, OF ESTIMATED PERCENTAGE S FOR POPULAT ION EST IMATE S Estimated percentages Base of Percentages 2 5 10 25 50 Shown in or or or or Thousands 98 95 90 75 500~. 1~1 1~8 2~4 3~5 4~0 1~000~. Oe8 1~2 1~7 2~5 2~9 2~000~e 0~6 0~9 1~2 1~S 2eO 5~000~e 0~4 0. 6 0.8 1.1 1~3 10 ~ 000. . 20~000~-~-e--~-- 30~000~. 50~000. 0~3 0~2 Oel 0.1 0~4 0~3 Oe 2 0~2 0.5 0.4 0~3 0~2 Oe 8 Oe6 0.5 0.4 0.9 0.6 0.5 0.4 1003000 0.0 0.1 0.2 0.2 0~3 1 - 5

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