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ENT-VSL-13.2 Data Details

ENT-VSL-13.2 Increase the proportion of adults who have tried recommended methods for treating their balance or dizziness problem

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)
24.4 (2008)
Target
26.8
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 tried recommended methods for treating their balance or dizziness problem
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:]

These next questions are about treatments for balance or dizziness problems.

Have you ever taken or tried anything to treat you most bothersome dizziness or balance problem such as physical therapy, certain exercises, avoiding certain foods, taking medicine, surgery, or wearing magnets or wristbands?

  1. Yes
  2. No

What treatments have you tried? Please say yes or no to each.

  1. Exercises or physical therapy (Do not include Tai Chi, Yoga, or Qi Gong)
  2. Head rolling maneuver by a doctor or therapist (Epley maneuver)
  3. Steroid injections into the ear
  4. Gentamicin injection into the ear
  5. Ear surgery
  6. Head or neck surgery
  7. Bed rest for several hours or days
  8. Psychiatric treatment
  9. Chiropractic treatment of manipulation
  10. Acupuncture
  11. Massage therapy
  12. Tai Chi, Yoga, or Qi Gong
  13. Hypnosis
  14. Low salt diet
  15. Avoiding or cutting back on certain foods or drinks such as chocolate, coffee or alcohol
  16. Quitting or reducing use of tobacco or cigarettes
  17. Prescription medicine or drugs
  18. Over the counter medicine such as aspirin, Tylenol, or Advil
  19. Herbal remedy such as feverfew leaf, ginger or ginkgo biloba
  20. Meniette device, air pressure pulses in ear
  21. Wearing acupressure wristband or Sea-Band
  22. Wearing magnets
  23. Mouth guard
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The percent is calculated by dividing the numerator [“yes” responses to (d) AND one of the listed responses to (e) AND “yes” response to (a) OR one or more of the six responses to (b); see questions] by the denominator [“yes” response to (a) OR one or more of the six responses to (b); see questions].

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. 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.

References

Additional resources about the objective.

  1. Gillespie LD, Gillespie WJ, Robertson MC, et al. 2004. Interventions for preventing falls in elderly people (Cochrane Review). In: The Cochrane Library, Issue 3. Chichester, UK: John Wiley & Sons, Ltd.
  2. Nelson D, Holtzman D, Bolen J, et al. 2001. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS). Int J Public Health. 46, S3-S35.
  3. Rubenstein LZ, Solomon DH, Roth CP, et al. 2004. Detection and management of falls and instability in vulnerable elders by community physicians. J Am Geriatr Soc. 52(9):1527–1531.