Differences by nativity status for cardiovascular disease (CVD) risk factors have been previously reported. Recent research has focused on understanding how other acculturation factors, such as length of residence, affect health behaviors and outcomes. This study examines the association between CVD risk factors and nativity/length of US residence. Using cross-sectional data from 15,965 adults in the 2011-2016 National Health and Nutrition Examination Surveys (analyzed in 2018), prevalence ratios and predicted marginals from logistic regression models are used to estimate associations of CVD risk factors (i.e., hypertension, hypercholesterolemia, diabetes, overweight/obesity and smoking) with nativity/length of residence (<15years, >/=15years) in the US. In sex-, age-, education- and race and Hispanic origin- adjusted analyses, a higher percentage of US (50 states and District of Columbia) born adults (86.4%) had >/=1 CVD risk factor compared to non-US born residents in the US <15years (80.1%) but not >/=15years (85.1%). Compared to US born counterparts, regardless of length of residence, hypertension overall and smoking among non-Hispanic white and Hispanic adults were lower among non-US born residents. Overweight/obesity overall and diabetes among Hispanic adults were lower among non-US born residents in the US <15years. In contrast, non-US born non-Hispanic Asian residents in the US <15years had higher prevalence of diabetes. Non-US born adults were less likely to have most CVD risk factors compared to US born adults regardless of length of residence, although, for smoking and diabetes this pattern differed by race and Hispanic origin.

INTRODUCTION: This study examined the association of spirometry-defined airflow obstruction and self-reported COPD defined as self-reported doctor diagnosed chronic bronchitis or emphysema, with occupational exposure among ever-employed US adults. METHODS: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2008 to 2011-2012, a nationally representative study of the non-institutionalized civilian US population. Reported current and/or longest held job were used to create prevalence estimates and prevalence odds ratios (PORs) (adjusted for age, gender, race, and smoking status) for airflow obstruction and self-reported COPD by occupational exposure, determined using both NHANES participants' self-reported exposures and eight categories of COPD job exposure matrix (JEM) assigned exposures. RESULTS: Significant PORs for airflow obstruction and self-reported COPD respectively were observed with self-reported exposure for >/=20 years to mineral dust (POR = 1.44; 95% confidence interval (CI) 1.13-1.85; POR = 1.69; 95% CI 1.17-2.43) and exhaust fumes (POR = 1.65; 95% CI 1.27-2.15; POR = 2.22; 95% CI 1.37-3.58). Airflow obstruction or self-reported COPD were also associated with COPD-JEM assigned high exposure to mineral dust, combined dust, diesel exhaust, vapor-gas, sensitizers, and overall exposure. CONCLUSION: Airflow obstruction and self-reported COPD are associated with both self-reported and JEM-assigned exposures.

INTRODUCTION: This study estimated the prevalence of spirometry-defined airflow obstruction by industry and occupation and chronic obstructive pulmonary disease (COPD) among ever-employed U.S. adults. METHODS: Data came from the National Health and Nutrition Examination Survey (NHANES) 2007-2008 to 2011-2012, a nationally representative study of the non-institutionalized civilian U.S. POPULATION: Data on respondent's current and/or longest held job were used to create prevalence estimates and adjusted prevalence odds ratios (PORs) for airflow obstruction and COPD. RESULTS: Among ever-employed U.S. adults, airflow obstruction prevalence was 12.40% and COPD was 3.47%. High airflow obstruction prevalence and significant PORs were reported in mining; manufacturing; construction; and services to buildings industries as well as extraction; bookbinders, prepress, and printing; installers and repairers; and construction occupations. CONCLUSION: Prevalence of airflow obstruction varies by industry and occupation. Industries and occupations with increased risk were identified using the most current NHANES data including detailed occupations and spirometry.

Objective: This study examined factors associated with prescription opioid analgesic use in the US population using data from a nationally representative sample. It focused on factors previously shown to be associated with opioid use disorder or overdose. Variations in the use of different strength opioid analgesics by demographic subgroup were also examined. Methods: Data came from respondents aged 16 years and older who participated in the National Health and Nutrition Examination Survey (2011-2014). Respondents were classified as opioid users if they reported using one or more prescription opioid analgesics in the past 30 days. Results: Opioid users reported poorer self-perceived health than those not currently using opioids. Compared with those not using opioids, opioid users were more likely to rate their health as being "fair" or "poor" (40.4% [95% confidence interval {CI} = 34.9%-46.2%] compared with 15.6% [95% CI = 14.3%-17.1%]), experienced more days of pain during the past 30 days (mean = 14.3 [95% CI = 12.9-15.8] days compared with 2.3 [95% CI = 2.0-2.7] days), and had depression (22.5% [95% CI = 17.3%-28.7%] compared with 7.1% [95% CI = 6.2%-8.0%]). Among those who reported using opioids during the past 30 days, 18.8% (95% CI = 14.4%-24.1%) reported using benzodiazepine medication during the same period and 5.2% (95% CI = 3.5%-7.7%) reported using an illicit drug during the past six months. When opioid strength was examined, a smaller percentage of adults aged 60 years and older used stronger-than-morphine opioids compared with adults aged 20-39 and 40-59 years. Conclusions: Higher percentages of current opioid users than nonusers reported having many of the factors associated with opioid use disorder and overdose.

Background: Screen time (ST) behaviours, for example, television (TV) watching and computer use, among youth are associated with unhealthy eating, and these patterns track over time. A positive association between ST and TV watching with consumption of caffeinated foods and beverages has been described in national samples of children in a few European countries. The association of ST behaviours with caffeine intake has not been previously reported. We examined whether ST behaviours were associated with caffeine intake on a given day (% consumers and amount consumed) in a nationally representative sample of US children. Methods: Data on 3421 children (ages 6-11 years) from the cross-sectional National Health and Nutrition Examination Survey 2007-2012 were used. Time spent on TV watching and computer use was determined using questionnaires. Dietary intake was assessed using a 24-hour recall by trained interviewers. Caffeine intake (mg) was estimated by using updated food and nutrient databases. Caffeine consumption was examined in relation to time spent (>/=2 vs<2 hours/day) on ST behaviours. Results: Children who watched TV >/=2 hours/day had significantly higher (~45% more) caffeine intake. Total ST or computer use was not associated with caffeine consumption in school-aged children. Conclusion: TV watching was positively associated with caffeine intake in school-aged children, suggesting the need for continued monitoring of ST and caffeine intake behaviours in children and adolescents as well as examining the correlates of these behaviours to inform nutrition and health policies.

Using data from a nationally representative study of the community-dwelling U.S. population, we estimated the percentage of male veterans who visited a mental health professional in the past year, compared it to an estimate from non-veteran males, and examined factors associated with visiting a mental health professional. We found that 10.5% of male veterans visited a mental health professional in the past year, compared to only 5.6% of male non-veterans. In the regression models, veteran status, sociodemographic factors, and healthcare utilization were independently associated with visiting a mental health professional. These findings demonstrate the importance of using nationally representative data to assess the mental healthcare needs of veterans.

OBJECTIVES: The objectives of this study were: to examine trends in the use of prescription antibiotics overall and by population subgroups between 1999 and 2012; and to examine trends in the use of categories of antibiotics and individual antibiotics. METHODS: Use of antibiotics was examined among 71 444 participants in the nationally representative National Health and Nutrition Examination Survey (NHANES; 1999-2012). Use of an antibiotic in the past 30 days was the main outcome variable. Analyses of trends were conducted overall and separately by population subgroups (i.e. age, sex, race/Hispanic origin, health insurance status and respiratory conditions) across four time periods (1999-2002, 2003-06, 2007-10 and 2011-12). RESULTS: The percentage of the US population that used a prescription antibiotic in the past 30 days significantly declined from 6.1% in 1999-2002 to 4.1% in 2011-12 (P < 0.001). Declines were also identified for five age groups (0-1 year, 6-11 years, 12-17 years, 18-39 years and 40-59 years), both sexes, non-Hispanic white and non-Hispanic black persons, persons with and without insurance and among those who currently had asthma. Significant declines were also observed for three categories of antibiotics (penicillins, cephalosporins and macrolide derivatives). Of the most common antibiotics prescribed, only amoxicillin use decreased significantly. CONCLUSIONS: Overall, there was a significant decline in the use of antibiotics between 1999-2002 and 2011-12. Due to concerns about antimicrobial resistance, it is important to continue monitoring the use of antibiotics.

PURPOSE: Prior studies of psychotropic medication use among US veterans are limited in their ability to generalize estimates to the full veteran population and make comparisons with non-veterans. This study estimated the prevalence of psychotropic medication use and trends over time among male US veterans, compared their use of psychotropic medications with non-veteran males, and examined differences among veteran subpopulations. METHODS: The data for our analysis came from the National Health and Nutrition Examination Survey (1999-2010), a cross-sectional, nationally representative study of the civilian, non-institutionalized US population. RESULTS: The percentage of male veterans who used any psychotropic medication increased from 10.4% in 1999-2002 to 14.3% in 2003-2006, then remained stable in 2007-2010 (14.0%). During the same time period, the percentage of non-veteran males who used psychotropic medications remained relatively stable (7.0%, 8.3%, and 9.2%, respectively). Veterans were more likely to use psychotropic medication, specifically antidepressants, than non-veterans. The percentage of non-Hispanic white veterans and veterans aged 60 years and over who used psychotropic medications increased between 1999-2002 and 2003-2006, but the percentages remained stable between 2003-2006 and 2007-2010. In 2003-2006 and 2007-2010, a higher percentage of non-Hispanic white veterans used psychotropic medications than non-Hispanic black veterans. CONCLUSIONS: This study found that the use of psychotropic medications and antidepressants was higher among male veterans than male non-veterans, and that prevalence of use increased between 1999-2002 and 2007-2010 for male veterans but remained relatively stable for non-veterans. There were significant variations in the use of psychotropic medications among veteran subpopulations.