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ENT-VSL-11 Data Details

ENT-VSL-11 Increase the proportion of adults with balance or dizziness problems in the past 12 months who have ever seen a health care provider about their balance or dizziness problems

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
48.4 (2008)
Target
53.2
Target-Setting Method
10 percent improvement
Numerator
Number of persons aged 18 years and over with dizziness or balance problems in the past 12 months who have ever seen a doctor or other Health Care professional, including visits to a hospital or emergency room
Denominator
Number of persons aged 18 years and over with dizziness or balance problems in the past 12 months
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey, Balance and Dizziness Supplement:

[NUMERATOR AND DENOMINATOR:]

DURING THE PAST 12 MONTHS, have you had a problem with dizziness or balance? Do not include times when drinking alcohol.

  1. Yes
  2. No

This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each.

  • A spinning or vertigo sensation, a rocking of yourself or your surroundings
    1. Yes
    2. No
  • A floating, spacey, or tilting sensation
    1. Yes
    2. No
  • Feeling lightheaded, without a sense of motion
    1. Yes
    2. No
  • Feeling as if you are going to pass out or faint
    1. Yes
    2. No
  • Blurring of your vision when you move your head
    1. Yes
    2. No
  • Feeling off-balance or unsteady
    1. Yes
    2. No

DURING THE PAST 12 MONTHS, which ONE of these feelings of dizziness or balance problems bothered you the most? [Read categories below.]

  1. Feeling a sense of spinning
  2. A floating or spacey feeling
  3. Feeling lightheaded
  4. Feeling like you are about to pass out
  5. Blurred vision
  6. Unsteadiness

[NUMERATOR:]

Have you ever gone to a hospital or emergency room about your most bothersome dizziness or balance problem?

  1. Yes
  2. No

Have you EVER seen a doctor or other health care professional, except for in the emergency room, about your most bothersome dizziness or balance problem?

  1. Yes
  2. No
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The numerator is calculated as the number of adults who responded: “Yes” to BHOSP or “Yes” to BHP. The denominator includes all the subjects who responded: “Yes” to BDIZZ or “Yes” to any of BTYPE_01 through BTYPE_06. By the number of adults, we mean the weighted sample number estimated for the U.S. population. The percent that is measured and tracked is calculated by dividing the numerator by the denominator.

Vestibular (inner ear balance) disorders can cause dizziness, vertigo, imbalance, problems with hearing, nausea, fatigue, anxiety, concentration, and other symptoms. They can deeply affect a person's day-to-day functioning, ability to work, social relationships, and quality of life. Balance is a state of body equilibrium or stability. We often take for granted how dependent we are on a healthy balance system. When the system breaks down, however, patients will describe symptoms such as dizziness, vertigo, lightheadedness, or motion sickness.

Several million people per year visit their doctor for vestibular or balance disorders. These disorders are among the most common complaints that lead patients to visit their primary care physicians. Furthermore, it is one of the most common reasons elderly people seek medical advice. Patients often describe balance problems in terms of vertigo, dizziness, lightheadedness, and motion sickness. Not all of these symptoms are caused by disorders of the vestibular system. Moreover, although one person may describe a balance problem using one or more of these terms, another person may use a different combination of these terms to describe the very same condition. In fact, some people use the word dizziness to indicate that they simply do not feel well. It is important, therefore, for patients to not use general terms when describing their balance problems. Patients are encouraged to simply describe the sensation they feel without using general terms like dizziness. One of the most important parts of the medical evaluation is the patient's description of the symptoms. As already mentioned, it is important for the patient to describe the details of what they are experiencing. The doctor will ask other important questions such as: How long and how often have they had the problem? Does the symptom of the balance problem occur in attacks or is it constant? Is it triggered by movement or by arising from a sitting or lying position? Is it associated with other symptoms such as hearing loss, ringing of the ears (tinnitus), ear fullness, nausea, or vomiting? Have there been any general health changes, new medications, recent head trauma, or recent or current infections? Are there any other neurological symptoms, such as weakness, vision problems, or tingling?

About 33.4 million adults (14.8%) reported they had a problem with dizziness or balance in the past 12 months. Their description of dizziness and balance problems included one or more of the following: a) a spinning or vertigo sensation, a rocking of yourself or your surroundings (as if riding a carousel), b) a floating, spacey, or tilting sensation, c) feeling lightheaded without a sense of motion, d) feeling as if you are going to pass out or faint, e) blurring of your vision when you move your head, or f) feeling off-balance or unsteady. After describing their symptoms, subjects participating in this survey were asked which symptom, if more than one occurred, bothered them the most. The most common response was unsteadiness (34%), followed by feeling lightheaded (21%), feeling like you are about to pass out (18%), a vertigo or spinning feeling (15%), blurred vision when moving head (6%), and least bothersome was a floating or spacey feeling (4%). For the most “bothersome” symptom, a number of follow-up questions were asked, for example, a) age when symptom first occurred, b) length of time they have had the problem in months or years, c) how often the problem has occurred in the past 12 months, d) how long each bout or spell lasts, e) what triggers the problem, etc. In addition, subjects answered questions about what accompanies the balance or dizziness problem, for example, nausea and vomiting, headaches (migraine or not), blurred vision, tinnitus, numbness in face, hands, or feet, etc.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 18-44, 45-64, 65-74, 75+
  • Sex: 18-44, 45-64, 65-74, 75+
  • Race/Ethnicity: 18-44, 45-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-64, 65-74, 75+
  • Family Income: 18-44, 45-64, 65-74, 75+
  • Family Type: 18-44, 45-64, 65-74, 75+
  • Country of Birth: 18-44, 45-64, 65-74, 75+
  • Disability Status: 18-44, 45-64, 65-74, 75+
  • Geographic Location: 18-44, 45-64, 65-74, 75+
  • Health Insurance Status: 18-44, 45-64
  • Marital Status: 18-44, 45-64, 65-74, 75+
Caveats and Limitations
The duration of an attack of vertigo is very helpful in determining the cause. Vertigo that follows head movement and lasts less than a minute is typical of benign positional vertigo. But an attack of vertigo lasting hours is more commonly due to Ménière’s disease. Constant vertigo, however, may indicate a central nervous system problem. A general physical examination of the ears, head, and neck should be done with special emphasis on tests of balance function. Additional testing is often recommended such as hearing tests, CT scans, MRI scans, electronystagmography (ENG), and blood tests. ENG is a technique to measure involuntary eye movements (nystagmus) that are related to balance disorders. In some situations, referral to an ear specialist (otolaryngologist), audiologist, or neurologist may also be necessary. In addition, consultations with a cardiologist, psychiatrist, and general internist are often indicated. Balance disorders can be unpredictable. Depending on the cause, the symptoms can occur at any time, even after long periods of absence of symptoms (remission). It is important, therefore, to take proper precautions in order to avoid accidents that could be caused by a balance disorder.
Trend Issues
A general physical examination of the ears, head, and neck should be done with special emphasis on tests of balance function. Additional testing is often recommended such as hearing tests, CT scans, MRI scans, electronystagmography (ENG), and blood tests. ENG is a technique to Changes since the measure involuntary eye movements (nystagmus) that are related to balance disorders. In some situations, referral to an ear specialist (otolaryngologist), audiologist, or neurologist may also be necessary. In addition, consultations with a cardiologist, psychiatrist, and general internist are often indicated. Balance disorders can be unpredictable. Depending on the cause, the symptoms can occur at any time, even after long periods of absence of symptoms (remission). It is important, therefore, to take proper precautions in order to avoid accidents that could be caused by a balance disorder.

References

Additional resources about the objective.

  1. Baloh RW. 1994. Approach to the dizzy patient. Baillieres Clin Neurol. 3(3):453–465.
  2. Hamilton SS. 2002. Evaluation of clumsiness in children. Am Fam Physician. 66(8):1435–1440.
  3. Hannaford PC, Simpson JA, Bisset AF, et al. 2005. The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland. Fam Pract. 22(3):227–233.