Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2012-161, 2012 Oct; :1-116
The ongoing collection, analysis, dissemination and use of population health data has been an integral part of the National Institute for Occupational Safety and Health (NIOSH) research program since the 1970s. In collaboration with its many partners, NIOSH has established programs to describe the magnitude of occupational hazards, diseases, and injuries in the United States. These activities document the nation's progress in reducing the burden of work-related diseases and injuries. These activities have continually identified new areas that require additional research and prevention efforts. Despite these accomplishments, occupational health surveillance in the United States remains fragmented, with substantial data gaps. NIOSH conducts a range of efforts in the area of research, guidance, information, and service. To better coordinate these efforts, NIOSH has adopted aspects of matrix management to both organize and manage its research portfolio. In 2005, NIOSH solicited the involvement of both intramural staff, and extramural partners and stakeholders, to develop the National Occupational Research Agenda (NORA) goals to advance the prevention of occupational injuries and illnesses for eight targeted sectors of U.S. industry: Agriculture, Forestry, and Fishing; Mining; Construction; Manufacturing; Wholesale and Retail Trade; Transportation, Warehousing, and Utilities; Healthcare and Social Assistance; and Services. As an integral part of the NIOSH Program Portfolio, the NIOSH Surveillance program has developed five strategic goals. These goals outline the major elements of a long-range plan for a comprehensive occupational surveillance program. These national goals seek to both strengthen and balance national and state-based partnerships, and support a comprehensive intramural program of illness, injury, and hazard surveillance activities. Occupational health surveillance is challenged to narrow many substantial data and information gaps. To this end, the NIOSH surveillance program promotes increased coordination and information exchange within NIOSH and among our many external partner organizations. One such organization is the Occupational Research Group at the University of Miami, Florida. This Group was funded in the past by NIOSH to study the U.S. employed population's morbidity and mortality using statistical resources publicly available through the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC).The focus of this report is to describe the prevalence of morbidity and disability among employed workers in the Healthcare and Social Assistance sector. This report is based on work products from comprehensive analyses performed by the Occupational Research Group at the University of Miami using an established methodology to assess predictors of acute and chronic disability morbidity for U.S. workers by the National Occupational Research Agenda (NORA) sectors using the 1997-2007 National Health Interview Survey (NHIS) data [Fleming et al. 2004; Fleming et al. 2005; Fleming et al. 2007a]. The National Health Interview Survey (NHIS) is a continuous multipurpose and multistage probability area in-person survey of the U.S. civilian non-institutionalized population living at addressed dwellings [NCHS 2000]. Each week a probability sample of households is interviewed by trained personnel to obtain information about the characteristics of each member of the household. Data from the NHIS include a range of measures of population health, acute and chronic disability, health care access, and individual risk factor and health behavior collected for all participants. After adjustment for sample weights and design effects, prevalence measures were estimated for workers ages 18 years and older for each of the eight NORA sectors; as well as by population subgroups categorized by age, gender, race, ethnicity, health insurance, and education. Additional information has been made available to allow for extrapolation to the entire U.S. worker population during the 1997-2007 study period. This report is one of a series of reports developed to describe the prevalence of disability and morbidity among current workers within these eight sectors. Survey data from the years 1997-2007 were used to describe the five aspects of worker's health, including (1) health status, (2) physical activity limitations or disability, (3) prevalent chronic conditions (cancer, hypertension, heart disease, asthma, diabetes, and severe psychological distress); (4) access to and use of health care services diseases; and (5) health risk factors or behaviors. The report was developed as a descriptive resource to supplement ongoing research, and guide occupational health research and research-to-practice activities within industry. NIOSH increasingly sees the value of integrating occupational safety and health programs that safeguard workers from work-related hazards and programs that promote overall well-being. This report provides data on characteristics of workers health that must be better understood to fulfill the mandate to assure safe and healthful working conditions and to preserve our human resources.