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Hearing and Other Sensory or Communication Disorders Data Details

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  • ENT-VSL-1 Increase the proportion of newborns who are screened for hearing loss by no later than age 1 month, have audiologic evaluation by age 3 months, and are enrolled in appropriate intervention services no later than age 6 months

    • ENT-VSL-1.1 Increase the proportion of newborns who are screened for hearing loss no later than age 1 month

      About the Data

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

      Data Source: 
      State-based Early Hearing Detection and Intervention Program Network
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent
      Baseline (Year): 
      82.0 (2007)
      Target: 
      90.2
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of newborns who received an objective physiological hearing screening procedure before 1 month of age

      Denominator: 

      Number of live births

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        Hearing screening procedures could include otoacoustic emissions (OAE), and/or auditory brainstem response (ABR).

      Trend Issues: 
      Estimates from 2007 are based on 48 states excluding DE and GA. Estimates from 2008 are based on 47 states and DC excluding CA, DE, and GA. Estimates from 2009 are based on 47 states excluding DE, NV, and WI. Estimates from 2010 are based on 49 states and DC excluding NH. Estimates from 2011 are based on 48 states and DC excluding GA and NH.
      Changes Between HP2010 and HP2020: 
      In 2005, the Early Hearing and Detection Intervention (EHDI) Network introduced the Hearing and Screening Followup Survey. This survey collects more complete data and includes more specific data definitions than the data collection procedures utilized prior to its implementation. Consequently, some of the rates reported for years prior to 2005 are lower and are not comparable with current data.
    • ENT-VSL-1.2 Increase the proportion of newborns who receive audiologic evaluation no later than age 3 months for infants who did not pass the hearing screening

      About the Data

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

      Data Source: 
      State-based Early Hearing Detection and Intervention Program Network
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent
      Baseline (Year): 
      66.0 (2007)
      Target: 
      72.6
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of newborns who did not pass a hearing screening and received a comprehensive diagnostic audiologic evaluation before 3 months of age

      Denominator: 

      Number of infants who did not pass a hearing screening test before 3 months of age

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        Comprehensive diagnostic audiologic evaluation includes physiologic measures and developmentally appropriate behavioral techniques.

      Trend Issues: 
      Estimates from 2007 are based on 48 states excluding DE and GA. Estimates from 2008 are based on 47 states and DC excluding CA, DE, and GA. Estimates from 2009 are based on 47 states excluding DE, NV, and WI. Estimates from 2010 are based on 49 states and DC excluding NH. Estimates from 2011 are based on 48 states and DC excluding GA and NH.
      Changes Between HP2010 and HP2020: 
      In 2005, the Early Hearing and Detection Intervention (EHDI) Network introduced the Hearing and Screening Followup Survey. This survey collects more complete data and includes more specific data definitions than the data collection procedures utilized prior to its implementation. Consequently, some of the rates reported for years prior to 2005 are lower and are not comparable with current data.
    • ENT-VSL-1.3 Increase the proportion of infants with confirmed hearing loss who are enrolled for intervention services no later than age 6 months

      About the Data

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

      Data Source: 
      State-based Early Hearing Detection and Intervention Program Network
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent
      Baseline (Year): 
      50.0 (2007)
      Target: 
      55.0
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of newborns with hearing loss who are enrolled in intervention services before age 6 months

      Denominator: 

      Number of infants who have been diagnosed with hearing loss before 6 months of age

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        Early intervention services can be public or private and are provided for a child’s hearing loss.

      Trend Issues: 
      Estimates from 2007 are based on 48 states excluding DE and GA. Estimates from 2008 are based on 47 states and DC excluding CA, DE, and GA. Estimates from 2009 are based on 47 states excluding DE, NV, and WI. Estimates from 2010 are based on 49 states and DC excluding NH. Estimates from 2011 are based on 48 states and DC excluding GA and NH.
      Changes Between HP2010 and HP2020: 
      In 2005, the Early Hearing and Detection Intervention (EHDI) Network introduced the Hearing and Screening Followup Survey. This survey collects more complete data and includes more specific data definitions than the data collection procedures utilized prior to its implementation. Consequently, some of the rates reported for years prior to 2005 are lower and are not comparable with current data.
  • ENT-VSL-2 Reduce otitis media in children and adolescents

    About the Data

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

    Data Source: 
    National Ambulatory Medical Care Survey
    National Hospital Ambulatory Medical Care Survey
    Population Estimates
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    per 1,000
    Baseline (Year): 
    246.6 (2007)
    Target: 
    221.9
    Target-Setting Method: 
    10 percent improvement
    Numerator: 

    Number of visits to ambulatory care facilities with a diagnosis of otitis media (any mention of ICD-9-CM codes 3810-3814, 382) among persons under age 18 years

    Denominator: 

    Number of persons under age 18 years

    Comparable Healthy People 2010 Objective: 
    Retained from HP2010 objective
    Data Collection Frequency: 
    Annual
    Methodology Notes: 

      Otitis media, commonly called ear infection, is an inflammation of the middle ear caused by viral or bacterial infection.

      The number of otitis media visits to ambulatory care facilities obtained from the National Ambulatory Medical Care Survey (NAMCS) are added to the number of visits obtained from the National Hospital Ambulatory Care Survey (NHAMCS).

      Ambulatory care facilities include physicians' offices, hospital emergency departments and outpatient departments.

      FOR SINGLE DATA YEARS: Ambulatory care visit rates are calculated using the July 1 estimates of the civilian noninstitutionalized population from the Vintage matching the data year for the postcensal period based on the 2000 census. For example, July 1, 2007 civilian noninstitutionalized population estimates from Vintage 2007 are used as the denominator for 2007 rates. Rates for 2010 are also calculated using the July 1 estimates based on the 2000 census.

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    In 2017, the original target was revised from 221.5 to 221.9 per 1,000 due to target recalculation based on 10% improvement target setting method.
  • ENT-VSL-3 Increase the proportion of persons with hearing impairments who have ever used a hearing aid or assistive listening devices or who have cochlear implants

    • ENT-VSL-3.1 Increase the proportion of adults aged 20 to 69 years with hearing loss who have ever used a hearing aid

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      per 1,000 (age adjusted—see Comments)
      Baseline (Year): 
      162.7 (2007)
      Target: 
      179.0
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 20–69 years who have ever worn a hearing aid

      Denominator: 

      Number of adults aged 20–69 years with hearing loss in either ear, defined as the pure-tone average of thresholds at {1000, 2000, 3000, and 4000 Hz} greater than or equal to 35dB

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2006 National Health Interview Survey:

        [NUMERATOR:]

        Do you now use a hearing aid(s)?

        1. Yes
        2. No
        3. Refused
        4. Don’t know

        Have you ever used a hearing aid(s) in the past?

        1. Yes
        2. No
        3. Refused
        4. Don’t know
      Data Collection Frequency: 
      Annual
      Methodology Notes: 

        A hearing aid is an electronic device that brings amplified sound to the ear, usually consisting of a microphone, amplifier, and receiver.

        A cochlear implant is a medical device that bypasses damaged structures in the inner ear and directly stimulates the auditory nerve, allowing some deaf individuals to hear and to maintain or develop speech and language.

        Assistive devices are technical tools and devices used to aid individuals who have communication disorders in performing actions, tasks, and activities. Examples include alphabet boards, text telephones (TT/TTY/TTD), and text-to-speech conversion software.

        The numerator for this objective, persons who respond that they have ever worn a hearing aid, is obtained annually from the National Health Interview Survey (NHIS). The denominator, persons testing as having hearing loss in either ear, is obtained from an average of the 1999-2004 National Health and Nutrition Examination Survey (NHANES).

        Age Adjustment Notes: 

        This Indicator uses Age-Adjustment Groups:

        • Total: 20-39, 40-59, 60-69
        • Sex: 20-39, 40-59, 60-69
        • Race/Ethnicity: 20-39, 40-59, 60-69
        • Educational Attainment: 25-39, 40-59, 60-69
        • Disability Status: 20-39, 40-59, 60-69
    • ENT-VSL-3.2 Increase the proportion of persons who are deaf or very hard of hearing and who have new cochlear implants

      About the Data

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

      Data Source: 
      Healthcare Cost and Utilization Project-Nationwide Inpatient Sample
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      Yes
      Measure: 
      per 10,000
      Baseline (Year): 
      76.8 (2004)
      Target: 
      84.5
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of cochlear implant surgeries in the U.S.

      Denominator: 

      Number of persons who are deaf or very hard of hearing

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2004 National Health Interview Survey:

        [DENOMINATOR:]

        Persons aged 18 years and over:

        What statement best describes your hearing without a hearing aid: good, a little trouble, a lot of trouble, deaf?

        1. Good
        2. A little trouble
        3. A lot of trouble
        4. Deaf
        5. Refused
        6. Don’t know

        Persons under age 18 years:

        Whiat statement best describes [fill: S.C. name]'s hearing without a hearing aid: good, a little trouble, a lot of trouble, deaf?

        1. Good
        2. A little trouble
        3. A lot of trouble
        4. Deaf
        5. Refused
        6. Don’t know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        A cochlear implant is a medical device that bypasses damaged structures in the inner ear and directly stimulates the auditory nerve, allowing some deaf stimulates the auditory nerve, allowing some deaf individuals to hear and to maintain or develop speech and language.

        The numerator for this measure, number of cochlear implant (CI) surgeries, is derived from two databases in the HCUP system, because CI surgeries can be performed as inpatient surgeries or, increasingly, on an ambulatory basis in hospital-affiliated clinics. These databases are:

        1) The Nationwide Inpatient Sample: The largest all-payer inpatient care database in the United States, which contains data on more than seven million hospital stays from approximately 1,000 hospitals. and

        2) The State Ambulatory Surgery Databases (SASD): State databases that capture records from hospital-affiliated ambulatory surgery sites on surgeries performed on the same day in which patients are admitted and discharged.

        CIs are coded in HCUP by ICD-9-CM procedure codes 20.96-20.98, which are used by all the hospitals or hospital-affiliated outpatient clinics included in HCUP.
        Annual CI surgery data from Nationwide Inpatient Sample are available as nationally-weighted estimates from HCUP, and can be further classified by age categories, gender, and race.

      Revision History

      Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

      Description of Changes Since the Healthy People 2020 Launch: 
      In 2017, the original target was revised from 84.7 to 84.5 per 10,000 due to target recalculation based on 10% improvement target setting method.

      References

      Additional resources about the objective

      1. For more information about HCUP, consult the internet at: HCUP Project Overview. Healthcare Cost and Utilization Project (HCUP). October 2003. Agency for Healthcare Research and Quality, Rockville, MD.

    • ENT-VSL-3.3 Increase the proportion of adults aged 70 years and older with hearing loss who have ever used a hearing aid

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      per 1,000
      Baseline (Year): 
      289.1 (2007)
      Target: 
      318.0
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 70 years and over who have ever worn a hearing aid

      Denominator: 

      Number of persons aged 70 years and over with hearing loss in either ear, defined as the pure-tone average of thresholds at {1000, 2000, 3000, and 4000 Hz} greater than or equal to 35 dB

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2006 National Health Interview Survey:

        [NUMERATOR:]

        Do you now use a hearing aid(s)?

        1. Yes
        2. No
        3. Refused
        4. Don’t know

        Have you ever used a hearing aid(s) in the past?

        1. Yes
        2. No
        3. Refused
        4. Don’t know
      Methodology Notes: 

        A hearing aid is an electronic device that brings amplified sound to the ear, usually consisting of a microphone, amplifier, and receiver. A cochlear implant is a medical device that bypasses damaged structures in the inner ear and directly stimulates the auditory nerve, allowing some deaf individuals to hear and to maintain or develop speech and language.
        Assistive devices are technical tools and devices used to aid individuals who have communication disorders in performing actions, tasks, and activities. Examples include alphabet boards, text telephones (TT/TTY/TTD), and text-to-speech conversion software.

        The numerator for this measure, adults aged 70 years or older who respond that they have ever worn a hearing aid, is obtained annually from the National Health Interview Survey (NHIS); the denominator, adults aged 70 years or older who testing as having hearing loss in either ear, is obtained from the 2005–06 National Health and Nutrition Examination Survey (NHANES).

    • ENT-VSL-3.4 Increase the proportion of adults aged 70 years and older with hearing loss who use assistive listening devices

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      per 1,000
      Baseline (Year): 
      100.0 (2005–06)
      Target: 
      110.0
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 70 years and over who have ever used assistive listening devices (ALDs), such as FM systems, closed-captioned television, or amplified telephone (or relay services)

      Denominator: 

      Number of person aged 70 years and over with hearing loss in either ear, defined as the pure-tone average of thresholds at {1000, 2000, 3000, and 4000 Hz} greater than or equal to 35 dB

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2005-06 National Health and Nutrition Examination Survey:

        [NUMERATOR:]

        Have you ever used assistive listening devices (ALDs), such as FM systems, closed-captioned television, or amplified telephone (or relay service)?

        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        A cochlear implant is a medical device that bypasses damaged structures in the inner ear and directly stimulates the auditory nerve, allowing some deaf individuals to hear and to maintain or develop speech and language. A hearing aid is an electronic device that brings amplified sound to the ear, usually consisting of a microphone, amplifier, and receiver.

        Assistive devices are technical tools and devices used to aid individuals who have communication disorders in performing actions, tasks, and activities. Examples include alphabet boards, text telephones (TT/TTY/TTD), and text-to-speech conversion software.

  • ENT-VSL-4 Increase the proportion of persons who have had a hearing examination on schedule

    • ENT-VSL-4.1 Increase the proportion of adults aged 20 to 69 years who have had a hearing examination in the past 5 years

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      Changed Since the Healthy People 2020 Launch: 
      Yes
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      21.3 (2011–12)
      Target: 
      23.4
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 20 to 69 years who have had a hearing examination within the past 5 years

      Denominator: 

      Number of persons aged 20 to 69 years

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2011-12 National Health and Nutrition Examination Survey:

        [NUMERATOR:]

        When was the last time you had your hearing tested by a hearing specialist?

        1. Less than 1 year ago
        2. 1 year to 4 years ago
        3. 5 to 9 years ago
        4. 10 or more years ago
        5. Never
        6. Refused
        7. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The numerator for this measure is estimated by all adults who responded “yes” to having their hearing tested “less than 1 year ago” or “1 year to 4 years ago.”

        Age Adjustment Notes: 

        This Indicator uses Age-Adjustment Groups:

        • Total: 20-29, 30-39, 40-49, 50-59, 60-69
        • Sex: 20-29, 30-39, 40-49, 50-59, 60-69
        • Race/Ethnicity: 20-29, 30-39, 40-49, 50-59, 60-69
        • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69
        • Family Income (percent poverty threshold): 20-29, 30-39, 40-49, 50-59, 60-69
        • Country of Birth: 20-29, 30-39, 40-49, 50-59, 60-69
        • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69
        • Health Insurance Status: 20-29, 30-39, 40-49, 50-59, 60-64
        • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69
        • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69

      Revision History

      Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

      Description of Changes Since the Healthy People 2020 Launch: 
      In 2015 the objective has been revised due to changes in the 2011-12 NHANES survey question. The 2003-04 baseline of 28.6% was replaced with 21.3% (2011-12), the target was adjusted from 31.5% to 23.4% to reflect the revised baseline using the original target setting method.
    • ENT-VSL-4.2 Increase the proportion of adults aged 70 years and older who have had a hearing examination in the past 5 years

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      Changed Since the Healthy People 2020 Launch: 
      Yes
      Measure: 
      percent
      Baseline (Year): 
      40.6 (2003–06)
      Target: 
      44.7
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 70 years and over who have had a hearing examination within the past 5 years

      Denominator: 

      Number of persons aged 70 years and over

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2003-04 National Health and Nutrition Examination Survey:

        [NUMERATOR:]

        About how long has it been since you last had your hearing tested?

        1. Less than 1 year ago
        2. 1 year to 4 years ago
        3. More than 4 years ago
        4. Never
        5. Refused
        6. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The numerator for this measure is estimated by all adults who responded “yes” to having their hearing tested “less than 1 year ago” or “1 year to 4 years ago.”

      Revision History

      Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

      Description of Changes Since the Healthy People 2020 Launch: 
      In 2017, the original target was revised from 42.4% to 44.7% due to target recalculation based on 10% improvement target setting method.
    • ENT-VSL-4.3 Increase the proportion of adolescents aged 12 to 19 years who have had a hearing examination in the past 5 years

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent
      Baseline (Year): 
      79.3 (2005–06)
      Target: 
      87.2
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 12 to 19 years who have had a hearing examination in the past 5 years

      Denominator: 

      Number of persons aged 12 to 19 years

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        Question used from the 2005-2006 NHANES:

        [NUMERATOR:]

        When was the last time you had your hearing tested?

        1. Less than a year ago
        2. 1 year to 4 years ago
        3. 5 to 9 years ago
        4. Ten or more years ago
        5. Never
        6. Refused
        7. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The numerator for this measure is estimated by all adolescents aged 12 to 19 years who responded “yes” to having had their hearing tested “less than 1 year ago” or “1 year to 4 years ago”.

  • ENT-VSL-5 Increase the number of persons who are referred by their primary care physician or other health care provider for hearing evaluation and treatment

    About the Data

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

    Data Source: 
    National Health Interview Survey
    Changed Since the Healthy People 2020 Launch: 
    No
    Measure: 
    per 1,000 (age adjusted—see Comments)
    Baseline (Year): 
    283.3 (2007)
    Target: 
    311.7
    Target-Setting Method: 
    10 percent improvement
    Numerator: 

    Number of persons aged 18 years and over who have seen a doctor or other health care professional about any hearing or ear problems in the past 5 years and then seen, or been referred by their primary care physician to: a hearing specialist, Ear, Nose, and Throat [ENT] doctor (otolaryngologist or otologist), an audiologist, or hearing aid dispenser

    Denominator: 

    Number of persons aged 18 years and over who have seen a doctor or other health care professional about any hearing or ear problems in the past 5 years

    Comparable Healthy People 2010 Objective: 
    Retained from HP2010 objective
    Questions Used to Obtain the National Baseline Data: 

      From the 2007 National Health Interview Survey Hearing Supplement:

      [NUMERATOR AND DENOMINATOR:]

      When was the last time you saw a doctor or other health care professional about any hearing or ear problems?

      1. Never
      2. In the past year
      3. 1 to 2 years ago
      4. 3 to 4 years ago
      5. 5 to 9 years ago
      6. 10 to 14 years ago
      7. 15 or more years ago
      8. Refused
      9. Don't know

      [NUMERATOR:]

      IN THE PAST 5 YEARS, have you seen or been referred by your doctor or other health care professional to
      a hearing specialist, such as an Ear, Nose, and Throat doctor?
      [Read if necessary:] Include an Otolaryngologist (OH-toh-LAYR-ehn-GAHL-oh-jist) or Otologist (OH-tol-o-jist).]

      1. Yes
      2. No
      3. Refused
      4. Don't know

      IN THE PAST 5 YEARS, have you seen or been referred by your doctor or other health care professional to
      an audiologist or hearing aid dispenser?

      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
      Age Adjustment Notes: 

      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 (percent poverty threshold): 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+
  • ENT-VSL-6 Increase the use of hearing protection devices

    • ENT-VSL-6.1 Increase the proportion of adults aged 20 to 69 years who have ever used hearing protection devices (earplugs, earmuffs) when exposed to loud sounds or noise (age adjusted to the year 2000 standard population)

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      per 1,000 (age adjusted—see Comments)
      Baseline (Year): 
      483.0 (2003–04)
      Target: 
      531.3
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 20 to 69 years who have ever worn a hearing protective device when exposed to loud sounds or noise

      Denominator: 

      Number of persons aged 20 to 69 years exposed to loud sounds or noise

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2003-04 National Health and Nutrition Examination Survey:

        [NUMERATOR AND DENOMINATOR:]

        Outside of work, have you ever been exposed to firearms noise for an average of at least once a month for a year?

        1. Yes
        2. No

        Outside of work, have you ever been exposed to other types of loud noise, such as noise from power tools or loud music, for an average of at least once a month for a year? By loud noise, I mean noise so loud that you have to speak in a raised voice to be heard.

        1. Yes
        2. No

        Have you ever been exposed to loud noise at work for at least 3 months? By loud noise, I mean noise so loud that you have to speak in a raised voice to be heard.

        1. Yes
        2. No

        At your job as a(n) {occupation} for{employer}, are you currently exposed to loud noise? By loud noise, I mean noise so loud that you have to speak in a raised voice to be heard.

        1. Yes
        2. No

        Remembering the kind of work you did the longest, that is, as {kind of work did the longest} were you ever exposed in that job to loud noise for at least three months? By loud noise I mean noise so loud that you had to speak in a raised voice to be heard.

        1. Yes
        2. No

        [NUMERATOR:]

        Have you ever worn hearing protection devices when exposed to firearms noise?

        1. Yes
        2. No

        Have you ever worn hearing protection devices when exposed to these loud noises? [This question refers to noises from sources like power tools or loud music.]

        1. Yes
        2. No

        [At work]Do you ever wear protective hearing devices?

        1. Yes
        2. No
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The numerator for this measure is estimated by all adults who responded “yes” to experiencing loud sounds or noises at or outside of work and who also responded “yes” to wearing protective hearing devices.

        Age Adjustment Notes: 

        This Indicator uses Age-Adjustment Groups:

        • Total: 20-29, 30-39, 40-49, 50-59, 60-69
        • Sex: 20-29, 30-39, 40-49, 50-59, 60-69
        • Race/Ethnicity: 20-29, 30-39, 40-49, 50-59, 60-69
        • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69
        • Family Income (percent poverty threshold): 20-29, 30-39, 40-49, 50-59, 60-69
        • Country of Birth: 20-29, 30-39, 40-49, 50-59, 60-69
        • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69
        • Health Insurance Status: 20-29, 30-39, 40-49, 50-59, 60-64
        • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69
        • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69
    • ENT-VSL-6.2 Increase the proportion of adolescents aged 12 to 19 years who have ever used hearing protection devices (earplugs, earmuffs) when exposed to loud sounds or noise

      About the Data

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

      Data Source: 
      National Health and Nutrition Examination Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      per 1,000
      Baseline (Year): 
      410.7 (2005–06)
      Target: 
      451.8
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 12 to 19 years who have ever worn a hearing protection device when they used firearms or when exposed to loud noise or music for 5 or more hours a week

      Denominator: 

      Number of persons aged 12 to 19 years who ever used firearms or who were ever exposed to loud noise or music for 5 or more hours a week

      Comparable Healthy People 2010 Objective: 
      Retained from HP2010 objective
      Questions Used to Obtain the National Baseline Data: 

        From the 2005-06 National Health and Nutrition Examination Survey:

        [NUMERATOR AND DENOMINATOR:]

        {Have you/Has SP} ever used firearms for target shooting, hunting, or for any other purposes?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        {Have you/Has SP} ever had a job where {you were/s/he was} exposed to loud noise for 5 or more hours a week? By loud noise I mean noise so loud that {you/s/he} had to speak in a raised voice to be heard.

        1. Yes
        2. No
        3. Refused
        4. Don't know

        Outside of a job, {have you/has SP} ever been exposed to steady loud noise or music for 5 or more hours a week? This is noise so loud that {you have/s/he has} to raise {your/his/her} voice to be heard. Examples are noise from power tools, lawn mowers, farm machinery, cars, trucks, motorcycles, or loud music.

        1. Yes
        2. No
        3. Refused
        4. Don't know

        [NUMERATOR:]

        How often {do you/does SP} wear hearing protection devices (ear plugs, ear muffs) when exposed to loud sounds or noise? (Include both job and off work exposures.)

        1. Most of the time
        2. Sometimes
        3. Rarely/seldom
        4. Never
        5. Refused
        6. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The numerator for this measure includes all respondents who said “yes” to ever using firearms or "yes" to ever having been exposed to loud noise or music for 5 hours a week at or outside of a job and who also responded ”most of the time”, “sometimes” or “rarely/seldom” to wearing protective hearing devices. The denominator includes all respondents who said “yes” to ever using firearms or "yes" to ever having been exposed to loud noise or music for 5 or more hours a week at or outside of a job.

  • ENT-VSL-7 Reduce the proportion of adolescents who have elevated hearing thresholds, or audiometric notches, in high frequencies (3, 4, or 6 kHz) in both ears, signifying noise-induced hearing loss

    About the Data

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

    Data Source: 
    National Health and Nutrition Examination Survey
    Changed Since the Healthy People 2020 Launch: 
    No
    Measure: 
    per 1,000
    Baseline (Year): 
    45.9 (2005–06)
    Target: 
    41.3
    Target-Setting Method: 
    10 percent improvement
    Numerator: 

    Number of persons aged 12 to19 years who have an audiometric notch in both ears

    Denominator: 

    Number of persons aged 12 to19 years

    Comparable Healthy People 2010 Objective: 
    Retained from HP2010 objective
    Data Collection Frequency: 
    Periodic
    Methodology Notes: 

      An audiometric threshold notch is present when one or more of the thresholds at 3, 4, or 6 kHz exceeds the pure-tone average of the 0.5 and 1 kHz thresholds by 15 dB or more, and the 8 kHz threshold is at least 5 dB lower (better) than the highest threshold in the 3 to 6 kHz range. Bilateral (present in both ears) notches are used to signify probable noise-induced hearing loss (NIHL).

      Children and adolescents with extremely high thresholds, 70 dB or greater, are excluded from the numerator, because the majority of such cases are not attributable to loud noise exposure.

  • ENT-VSL-8 Reduce the proportion of adults who have elevated hearing thresholds, or audiometric notches, in high frequencies (3, 4, or 6 kHz) in both ears, signifying noise-induced hearing loss

    About the Data

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

    Data Source: 
    National Health and Nutrition Examination Survey
    Changed Since the Healthy People 2020 Launch: 
    No
    Measure: 
    per 1,000 (age adjusted—see Comments)
    Baseline (Year): 
    121.4 (2003–04)
    Target: 
    109.3
    Target-Setting Method: 
    10 percent improvement
    Numerator: 

    Number of persons aged 20 to 69 years who have an audiometric notch in both ears

    Denominator: 

    Number of persons aged 20 to 69 years

    Comparable Healthy People 2010 Objective: 
    Retained from HP2010 objective
    Data Collection Frequency: 
    Periodic
    Methodology Notes: 

      An audiometric threshold notch is present when one or more of the thresholds at 3, 4, or 6 kHz exceeds the pure-tone average of the 0.5 and 1 kHz thresholds by 15 dB or more, and the 8 kHz threshold is at least 5 dB lower (better) than the highest threshold in the 3 to 6 kHz range. Bilateral (present in both ears) notches are used to signify probable noise-induced hearing loss (NIHL) if there is also a response indicating exposure to loud sounds or noise occupationally or in leisure activities.

      Age Adjustment Notes: 

      This Indicator uses Age-Adjustment Groups:

      • Total: 20-29, 30-39, 40-49, 50-59, 60-69
      • Sex: 20-29, 30-39, 40-49, 50-59, 60-69
      • Race/Ethnicity: 20-29, 30-39, 40-49, 50-59, 60-69
      • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69
      • Family Income (percent poverty threshold): 20-29, 30-39, 40-49, 50-59, 60-69
      • Country of Birth: 20-29, 30-39, 40-49, 50-59, 60-69
      • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69
      • Health Insurance Status: 20-29, 30-39, 40-49, 50-59, 60-64
      • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69
      • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69
  • ENT-VSL-9 Increase the proportion of adults bothered by tinnitus who have seen a doctor or other health care professionals

    • ENT-VSL-9.1 Increase the proportion of adults bothered by tinnitus in the past 12 months who have seen a doctor

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      44.5 (2007)
      Target: 
      48.9
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 18 years and over who have been bothered with tinnitus (ringing, roaring, or buzzing in the ears or head that lasts for 5 or more minutes) in the past 12 months and who have discussed their tinnitus problem with their doctor or other health care professional

      Denominator: 

      Number of persons aged 18 years and over who have been bothered with tinnitus (ringing, roaring, or buzzing in the ears or head that lasts for 5 or more minutes)  in the past 12 months

      Comparable Healthy People 2010 Objective: 
      Not applicable
      Questions Used to Obtain the National Baseline Data: 

        From the 2007 National Health Interview Survey, Hearing Supplement:

        [NUMERATOR AND DENOMINATOR:]

        IN THE PAST 12 MONTHS, have you been bothered by ringing, roaring, or buzzing in your ears or head that lasts for 5 minutes or more? [Read if necessary:] Tinnitus (TIN-uh-tus) is the medical term for ringing, roaring or buzzing in the ears or head.

        1. Yes
        2. No
        3. Refused
        4. Don't know

        [NUMERATOR:]

        Have you ever discussed this ringing, roaring or buzzing in your ears or head with your doctor or other health care professional?

        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        Each year approximately one in 10 Americans experience some form of tinnitus, or ringing in the ears, that lasts longer than 5 minutes per episode. These tinnitus sounds are perceived to originate in the ears or head; they are subjective experiences that cannot be heard by others standing nearby and are not objectively measurable with devices.

        The mechanisms that produce subjective tinnitus are not well understood. Typically, causes of hearing loss also cause tinnitus, including noise exposure, aging, trauma (head or neck injury), and medications. People react very differently to tinnitus and their reactions over months and years will probably change, some are able to habituate to their tinnitus successfully. They may find it a little bothersome, but largely ignore it. Others are distressed by tinnitus and have difficulty concentrating and getting to sleep. Importantly, tinnitus can be a symptom of a serious illness, which is why tinnitus should be discussed with a doctor or other health care professional.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      References

      Additional resources about the objective

      1. Ciocon JO, Amede R, Lechtenberg C, Aster F. 1995. Tinnitus: a stepwise workup to quiet the noise within. Geriatrics. 50: 18–25.
      2. Crummer RW, Hassan GA. Diagnostic approach to tinnitus. 2004. Am Fam Physician. 69: 120–126.
      3. Degive C, Kos M-I. 2006. Joint medico-psychological consultation for patients suffering from tinnitus. ORL. 68: 38–42.
    • ENT-VSL-9.2 Increase the proportion of adults bothered by the onset of tinnitus in the past 5 years for whom it is a moderate, big, or very big problem, who have seen or been referred to an audiologist or otolaryngologist (ENT physician)

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      45.8 (2007)
      Target: 
      50.4
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 18 years and over with onset of tinnitus within the past five years, for whom it is a moderate, big, or very big problem, and who have seen or been referred to a hearing specialist

      Denominator: 

      Number of persons aged 18 years and over with onset of tinnitus within the past five years, for whom it is a moderate, big, or very big problem

      Comparable Healthy People 2010 Objective: 
      Not applicable
      Questions Used to Obtain the National Baseline Data: 

        From the 2007 National Health Interview Survey, Hearing Supplement:

        [NUMERATOR AND DENOMINATOR:]

        IN THE PAST 12 MONTHS, have you been bothered by ringing, roaring, or buzzing in your ears or head that lasts for 5 minutes or more? [Read if necessary:] Tinnitus (TIN-uh-tus) is the medical term for ringing, roaring or buzzing in the ears or head.

        1. Yes
        2. No
        3. Refused
        4. Don't know

        How long have you been bothered by this ringing, roaring, or buzzing in your ears or head?

        1. Less than 3 months
        2. 3 to 11 months
        3. 1 to 2 years
        4. 3 to 4 years
        5. 5 to 9 years
        6. 10 to 14 years
        7. 15 years or more
        8. Refused
        9. Don't know

        How much of a problem is this ringing, roaring, or buzzing in your ears or head?

        1. No problem
        2. A small problem
        3. A moderate problem
        4. A big problem
        5. A very big problem
        6. Refused
        7. Don't know

        [NUMERATOR:]

        Have you ever discussed this ringing, roaring or buzzing in your ears or head with your doctor or other health care professional?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        IN THE PAST 5 YEARS, have you seen or been referred by your doctor or other health care professional to a ...Hearing specialist, such as an Ear, Nose, and Throat doctor? [Read if necessary:] Include an Otolaryngologist (OH-toh-LAYR-ehn-GAHL-oh-jist) or Otologist (OH-tol-o-jist).

        1. Yes
        2. No
        3. Refused
        4. Don't know

        IN THE PAST 5 YEARS, have you seen or been referred by your doctor or other health care professional to ... An audiologist or hearing aid dispenser?

        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The denominator includes the those persons who responded that have been bothered by tinnitus in the past 12 months, that they have had the problem for less than 5 years, and that the issue is a moderate, big, or very big problem. The numerator includes persons in the denominator who (1) responded “yes” to having discussed the problem with their doctor and “yes” to having been seen by or referred to a hearing specialist or (2) “yes” to having been seen by or referred to an audiologist or (3) “yes” to both having been seen by or referred to a hearing specialist and an audiologist.

        Tinnitus may occur at any age and is frequently associated with sensorineural hearing loss. Some tinnitus patients find moderately intense sounds very uncomfortable. This is called hyperacusis; when present, hyperacusis should be treated with the tinnitus. Recent onset of tinnitus may be related to changes in the auditory system that should be evaluated. Longstanding tinnitus can be difficult for many people to tolerate and may warrant treatment or interventions to reduce its impact on daily life. Tinnitus frequently affects emotional well-being, hearing, sleep, and concentration.

        Some people have tinnitus so severe and stressful that it interferes with their ability to lead a normal life. The onset or worsening of tinnitus should be reported to one’s Health Care provider since it may reflect a recent health-related event, use of medications, etc., that may be treatable. If the patient is not helped by his/her primary Health Care provider, then he/she should be referred for care by a hearing specialist, an audiologist or otolaryngologist (Ear, Nose, and Throat [ENT] physician), who is trained to provide care for tinnitus patients. Especially for people who have experienced a recent onset of tinnitus, or worsening of their tinnitus, a complete medical examination is recommended to be able to determine if there is a serious illness that can be treated medically or surgically. There are several treatments that can help people who are bothered by tinnitus, including: a) counseling, b) sound therapy, c) hearing aids, d) psychological therapies, and e) medications.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      References

      Additional resources about the objective

      1. Ciocon JO, Amede R, Lechtenberg C, Aster F. 1995. Tinnitus: a stepwise workup to quiet the noise within. Geriatrics. 50: 18–25.
      2. Crummer RW, Hassan GA. Diagnostic approach to tinnitus. 2004. Am Fam Physician. 69: 120–126.
      3. Degive C, Kos M-I. 2006. Joint medico-psychological consultation for patients suffering from tinnitus. ORL. 68: 38–42.
  • ENT-VSL-10 Increase the proportion of adults for whom tinnitus is a moderate to severe problem who have tried appropriate treatments

    About the Data

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

    Data Source: 
    National Health Interview Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent (age adjusted—see Comments)
    Baseline (Year): 
    14.7 (2007)
    Target: 
    16.2
    Target-Setting Method: 
    10 percent improvement
    Numerator: 

    Number of persons aged 18 years and over for whom tinnitus is a moderate, big, or very big problem and who have tried appropriate treatments such as masking or sound therapy, cognitive therapy, tinnitus retraining therapy, psychiatric treatment, drugs/medications, nutritional supplements, or surgery

    Denominator: 

    Number of persons aged 18 years and over who have been bothered with tinnitus (ringing, roaring, or buzzing in the ears or head that lasts for 5 or more minutes) and for whom it is a moderate, big, or very big problem

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Questions Used to Obtain the National Baseline Data: 

      From the 2007 National Health Interview Survey, Hearing Supplement:

      [NUMERATOR AND DENOMINATOR:]

      IN THE PAST 12 MONTHS, have you been bothered by ringing, roaring, or buzzing in your ears or head that lasts for 5 minutes or more? [Read if necessary:] Tinnitus (TIN-uh-tus) is the medical term for ringing, roaring or buzzing in the ears or head.

      1. Yes
      2. No
      3. Refused
      4. Don't know

      How much of a problem is this ringing, roaring, or buzzing in your ears or head?

      1. No problem
      2. A small problem
      3. A moderate problem
      4. A big problem
      5. A very big problem
      6. Refused
      7. Don't know

      [NUMERATOR:]

      Have you ever tried any remedies or treatments for this ringing, roaring, or buzzing in your ears or head?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Which of the following treatments have you tried? [Enter all that apply.]

      1. Amplification/Hearing aids
      2. Masking with wearable device (with or without hearing aids)
      3. Masking with non-wearable device (sound generators to help with sleep)
      4. Cognitive therapy with counseling
      5. Stress reduction or relaxation methods
      6. Biofeedback
      7. Tinnitus retraining therapy (TRT)
      8. Psychiatric treatment
      9. Surgery to cut the hearing nerve
      10. Drugs or medications
      11. Nutritional supplements
      12. Music therapy
      13. Temporal mandibular joint treatment
      14. Alternative methods (hypnosis, acupuncture, etc.)
      15. Other
      16. Refused
      17. Don't know
    Data Collection Frequency: 
    Periodic
    Methodology Notes: 

      The denominator includes those persons who responded that have been bothered by tinnitus in the past 12 months, and that the issue is a moderate, big, or very big problem. The numerator includes persons in the denominator who (1) responded “yes” or “no” to having tried treatments and (2) “yes” to any of the first 14 types of treatment listed.

      Tinnitus, often described as a ringing or buzzing sound in the ear, is a symptom that can be related to almost every known hearing problem. Tinnitus is not a disease, but it can be caused by exposure to loud sounds, middle or inner ear infections, tumors on the hearing nerve, and even wax on the eardrum. Sometimes tinnitus can be medically or surgically treated.

      Age Adjustment Notes: 

      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 (percent poverty threshold): 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+

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    In 2015 the objective has been revised due to changes in programming. The 2007 baseline of 80.9% was replaced with 14.7%, the target was adjusted from 89.0% to 16.2% to reflect the revised baseline using the original target setting method.

    References

    Additional resources about the objective

    1. Davis PB, Paki B, Hanley PJ. 2007. Neuromonics tinnitus treatment: third clinical trial. Ear Hear. 28(2):242–259.
    2. Dobie RA. 2003. Depression and tinnitus. Otolaryngol Clin North Am. 36(2):383–388.
  • 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.

    Data Source: 
    National Health Interview Survey
    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

    Comparable Healthy People 2010 Objective: 
    Not applicable
    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
      3. Refused
      4. Don't know

      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
      3. Refused
      4. Don't know
    • A floating, spacey, or tilting sensation
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Feeling lightheaded, without a sense of motion
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Feeling as if you are going to pass out or faint
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Blurring of your vision when you move your head
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Feeling off-balance or unsteady
      1. Yes
      2. No
      3. Refused
      4. Don't know

      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
      7. Refused
      8. Don't know

      [NUMERATOR:]

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

      1. Yes
      2. No
      3. Refused
      4. Don't know

      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
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
    Methodology Notes: 

      The denominator includes those persons who responded “yes” to having a balance or dizziness problem in the past 12 months or who responded “yes” to having any of the six listed symptoms of balance or dizziness problems. The numerator includes those persons who responded “yes” to having a balance or dizziness problem in the past 12 months or who responded “yes” to having any of the six listed symptoms of balance or dizziness problems AND who also responded “yes” to either (1) having gone to a hospital or emergency room or (2) seen a doctor or other health professional about their most bothersome balance or dizziness problem.

      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. The vestibular and balance disorders are among the most common complaints that lead patients to visit their primary care physicians and are one of the most common reasons elderly people seek medical advice.

      Age Adjustment Notes: 

      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 (percent poverty threshold): 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+

    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.
  • ENT-VSL-12 Increase the proportion of adults with moderate to severe balance or dizziness problems who have seen or been referred to a health care specialist for evaluation or treatment

    About the Data

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

    Data Source: 
    National Health Interview Survey
    Changed Since the Healthy People 2020 Launch: 
    No
    Measure: 
    percent (age adjusted—see Comments)
    Baseline (Year): 
    65.4 (2008)
    Target: 
    72.0
    Target-Setting Method: 
    10 percent improvement
    Numerator: 

    Number of persons aged 18 years and over for whom dizziness, vertigo, or imbalance (unsteadiness) is a moderate, big, or very big problem and who have been seen by, or referred to, a Health Care specialist such as an ENT (Ear, Nose, and Throat physician), an audiologist, a neurologist, a cardiologist, an internist, a podiatrist (foot doctor), a physical therapist, an occupational therapist, or other specialist

    Denominator: 

    Number of persons aged 18 years and over for whom dizziness, vertigo, or imbalance (unsteadiness) is a moderate, big, or very big problem

    Comparable Healthy People 2010 Objective: 
    Not applicable
    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
      3. Refused
      4. Don't know

      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
      3. Refused
      4. Don't know
    • A floating, spacey, or tilting sensation
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Feeling lightheaded, without a sense of motion
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Feeling as if you are going to pass out or faint
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Blurring of your vision when you move your head
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Feeling off-balance or unsteady
      1. Yes
      2. No
      3. Refused
      4. Don't know

      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
      7. Refused
      8. Don't know

      DURING THE PAST 12 MONTHS, how much of a problem was your dizziness or balance condition?

      1. No problem
      2. A small problem
      3. A moderate problem
      4. A big problem
      5. A very big problem
      6. Refused
      7. Don't know

      [NUMERATOR:]

      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
      3. Refused
      4. Don't know

      Which of the following types of doctors or health care professionals have you seen about your most bothersome dizziness or balance problem? Please say Yes or No to each.

      • Cardiologist or doctor of internal medicine
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Ear, nose, and throat doctor
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Neurologist
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Eye doctor, optometrist, or ophthalmologist
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Podiatrist or foot doctor
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Psychiatrist, psychologist or social worker
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Occupational therapist, physical therapist, or rehabilitation specialist
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Radiologist or technician for MRI, CAT scan or ultrasound
      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
    Methodology Notes: 

      The denominator includes those persons who responded “yes” to having a balance or dizziness problem in the past 12 months and who said it was a moderate, big, or very big problem. The numerator includes those persons who responded “yes” to having a balance or dizziness problem in the past 12 months; who said it was a moderate, big, or very big problem; AND who also responded “yes” to having been referred to or seen a health care professional in one of the listed specialties.

      Vestibular disorders, which encompass dizziness and balance problems, occur as significant problems (i.e., judged to be “moderate”, “big”, or “very big” problems). Vestibular impairment is an underlying cause in as many of 45% of patients complaining of “dizziness”. Many vestibular disorder can be treated effectively; however the diagnosis is frequently missed, particularly in older patients. Not all the complaints of dizziness, vertigo, or disequilibrium are symptoms that result from vestibular disorders; some problems are the result of neurologic, vascular, psychological, and even orthopedic pathology. As such, it is not always clear which specialty is appropriate for referral. Consequently, the primary care physician must make important decisions as to the appropriateness and cost-effectiveness of diagnostic procedures and referrals to specialists.

      Age Adjustment Notes: 

      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 (percent poverty threshold): 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+

    References

    Additional resources about the objective

    1. Bhattacharyya N, Baugh RF, Orvidas L, et al. 2008. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 139(5 Suppl 4):S47–8
    2. Cohen HS. 2006. Disability and rehabilitation in the dizzy patient. Curr Opin Neurol. 19(1):49–54.
    3. Konrad HR, Girardi M, Helfert R. 1999. Balance and aging. Laryngoscope. 109:1454–1460.
  • ENT-VSL-13 Increase the proportion of persons who have tried recommended methods for treating their balance or dizziness problems

    • ENT-VSL-13.1 Increase the proportion of children 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.

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      Yes
      Measure: 
      percent
      Baseline (Year): 
      30.7 (2012)
      Target: 
      Not applicable
      Target-Setting Method: 
      This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
      Numerator: 

      Number of children aged 3 to 17 years who used recommended treatment by health professional about dizziness or balance problem during the past 12 months

      Denominator: 

      Number of children aged 3 to 17 years with reported dizziness or balance problem during the past 12 months

      Comparable Healthy People 2010 Objective: 
      Not applicable
      Questions Used to Obtain the National Baseline Data: 

        From the 2012 National Health Interview Survey, Balance and Dizziness Supplement:

        [NUMERATOR AND DENOMINATOR:]

        DURING THE PAST 12 MONTHS, has {Sample Child’s name} been bothered by episodes of any of the following dizziness or balance problems.

      • a spinning sensation or vertigo feeling with a sense of movement, such as rocking of oneself or as if riding a Merry-Go-Round?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • poor balance, an unsteady or woozy feeling that makes it difficult to stand up or walk?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • problems with body or motor coordination or clumsiness?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • frequent, unexpected falls? *If asked, specify: if fall EVER happened more than once a week.
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • feeling light-headed, fainting, or feeling {fill2: he/she} is about to pass out?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • blurred vision when head is moving, or rapid eye movements known as “bouncing” eyes causing disorientation?
        1. Yes
        2. No
        3. Refused
        4. Don't know

        any other type of balance or dizziness problems?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        [NUMERATOR:]

        DURING THE PAST 12 MONTHS, has {fill: Sample Child’s name} tried methods recommended by a doctor, physical or occupational therapist, or other health care professional for treating his/her episodes of dizziness or balance problems?

        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic

      Revision History

      Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

      Description of Changes Since the Healthy People 2020 Launch: 
      The objective was moved from developmental to informational.

      References

      Additional resources about the objective

      1. Klein, R.J.; Proctor, S.E.; Boudreault, M.A.; Turczyn, K.M. Healthy People 2010 Criteria for Data Suppression. Statistical Notes No. 24. Hyattsville, MD: National Center for Health Statistics. 2002.
    • 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.

      Data Source: 
      National Health Interview Survey
      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

      Comparable Healthy People 2010 Objective: 
      Not applicable
      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
        3. Refused
        4. Don't know

        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
        3. Refused
        4. Don't know
      • A floating, spacey, or tilting sensation
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling lightheaded, without a sense of motion
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling as if you are going to pass out or faint
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Blurring of your vision when you move your head
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling off-balance or unsteady
        1. Yes
        2. No
        3. Refused
        4. Don't know

        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
        7. Refused
        8. Don't know

        [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
        3. Refused
        4. Don't know

        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
        24. Refused
        25. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The denominator includes those persons who responded “yes” to having a problem with dizziness or balance in the past 12 months or “yes” to one or more of the six symptoms listed. The numerator includes persons who responded “yes” to having a problem with dizziness or balance or “yes” to one or more of the six symptoms AND responded “yes” to having tried treatments for their most bothersome dizziness or balance problem and “yes” to one of the listed treatments.

        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. The vestibular or balance disorders are among the most common complaints that lead patients to visit their primary care physicians and are one of the most common reasons elderly people seek medical advice.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      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.
  • ENT-VSL-14 Reduce the proportion of adults with balance and dizziness problems who experienced negative or adverse outcomes in the past 12 months

    • ENT-VSL-14.1 Reduce the proportion of adults with balance and dizziness problems in the past 12 months who reported their condition got worse or did not improve

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      61.5 (2008)
      Target: 
      55.3
      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 whose dizziness or balance problem has stayed the same or gotten worse

      Denominator: 

      Number of persons aged 18 years and over with dizziness or balance problems in the past 12 months

      Comparable Healthy People 2010 Objective: 
      Not applicable
      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
        3. Refused
        4. Don't know

        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
        3. Refused
        4. Don't know
      • A floating, spacey, or tilting sensation
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling lightheaded, without a sense of motion
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling as if you are going to pass out or faint
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Blurring of your vision when you move your head
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling off-balance or unsteady
        1. Yes
        2. No
        3. Refused
        4. Don't know

        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
        7. Refused
        8. Don't know

        [NUMERATOR:]

        These next questions are about whether the subject's balance or dizziness problems got worse, stayed the same or improved in past 12 months.

        DURING THE PAST 12 MONTHS, has you most bothersome dizziness or balance problem gotten worse, stayed the same, improved somewhat, or improved greatly?

        1. Gotten worse
        2. Stayed the same
        3. Improved somewhat
        4. Improved greatly
        5. Refused
        6. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The denominator includes those persons who responded “yes” to having a problem with dizziness or balance in the past 12 months or “yes” to one or more of the six symptoms listed. The numerator includes persons who responded “yes” to having a problem with dizziness or balance or “yes” to one or more of the six symptoms AND who said that their dizziness or balance problem had gotten worse or stayed the same.

        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. The vestibular or balance disorders are among the most common complaints that lead patients to visit their primary care physicians and are one of the most common reasons elderly people seek medical advice.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      References

      Additional resources about the objective

      1. Badke MB, Miedaner JA, Shea TA, et al. 2005. Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap. Ann Otol Rhinol Laryngol. 114(1 Pt 1):48–54.
      2. Cohen H, Kimball KT. 2000. Development of the vestibular disorders activities of daily living scale. Arch Otolaryngol Head Neck Surg. 126: 881–887.
      3. Hillier SL, Hollohan V. 2007. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. Oct 17;(4):CD005397.
    • ENT-VSL-14.2 Reduce the proportion of adults with balance and dizziness problems in the past 12 months who were prevented from doing regular activities within the home or outside

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      23.3 (2008)
      Target: 
      21.0
      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 whose dizziness or balance problem prevented them from doing things they otherwise could do

      Denominator: 

      Number of adults (18+ years) with dizziness or balance problems in the past 12 months

      Comparable Healthy People 2010 Objective: 
      Not applicable
      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
        3. Refused
        4. Don't know

        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
        3. Refused
        4. Don't know
      • A floating, spacey, or tilting sensation
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling lightheaded, without a sense of motion
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling as if you are going to pass out or faint
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Blurring of your vision when you move your head
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling off-balance or unsteady
        1. Yes
        2. No
        3. Refused
        4. Don't know

        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
        7. Refused
        8. Don't know

        [NUMERATOR:]

        These next questions are about whether subject's balance or dizziness problems prevented them from doing things that they otherwise could do during past 12 months.

        Do your dizziness or balance problems prevent you in any way from doing things you otherwise could do?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        Have your dizziness or balance problems caused you to change or cut back on any of the following activities? Please say yes or no to each.

        • Work or school
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Driving a motor vehicle
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Riding in a car, bus, airplane, boat or train
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Exercising or taking walks
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Standing or being on your feet for 30 minutes or longer
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Walking down a flight of stairs
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Walking or climbing up 10 steps without resting
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Going outside your home for shopping, movies, sporting or other events
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Participating in social activities such as visiting friends, attending clubs and meetings, or going to parties
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Bathing yourself, dressing yourself, feeding yourself, or going to the toilet
        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The denominator includes those persons who responded “yes” to having a problem with dizziness or balance in the past 12 months or “yes” to one or more of the six symptoms listed. The numerator includes persons who responded “yes” to having a problem with dizziness or balance or “yes” to one or more of the six symptoms AND who responded that their dizziness or balance problem prevented them from doing things they could otherwise do and also responded “yes” to not being able to do one or more of the listed activities because of their balance or dizziness problem.

        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. The vestibular or balance disorders are among the most common complaints that lead patients to visit their primary care physicians and are one of the most common reasons elderly people seek medical advice.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      References

      Additional resources about the objective

      1. Badke MB, Miedaner JA, Shea TA, et al. 2005. Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap. Ann Otol Rhinol Laryngol. 114(1 Pt 1):48–54.
      2. Cohen H, Kimball KT. 2000. Development of the vestibular disorders activities of daily living scale. Arch Otolaryngol Head Neck Surg. 126: 881–887.
      3. Hillier SL, Hollohan V. 2007. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. Oct 17;(4):CD005397.
    • ENT-VSL-14.3 Reduce the proportion of adults who have missed days of work or school in the past 12 months because of balance and dizziness problems

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      14.5 (2008)
      Target: 
      13.0
      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 missed days of work or school because of their dizziness or balance problems

      Denominator: 

      Number of persons aged 18 years and over with dizziness or balance problems in the past 12 months

      Comparable Healthy People 2010 Objective: 
      Not applicable
      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
        3. Refused
        4. Don't know

        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
        3. Refused
        4. Don't know
      • A floating, spacey, or tilting sensation
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling lightheaded, without a sense of motion
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling as if you are going to pass out or faint
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Blurring of your vision when you move your head
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling off-balance or unsteady
        1. Yes
        2. No
        3. Refused
        4. Don't know

        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
        7. Refused
        8. Don't know

        [NUMERATOR:]

        These next questions are about whether subject's balance or dizziness problems caused them to miss days of school or work in the past year.

        DURING THE PAST 12 MONTHS, how many days of work or school have you missed because of your dizziness or balance problem? (Response categories: 0 to 365)

      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The denominator includes those persons who responded “yes” to having a problem with dizziness or balance in the past 12 months or “yes” to one or more of the six symptoms listed. The numerator includes persons who responded “yes” to having a problem with dizziness or balance or “yes” to one or more of the six symptoms AND who responded that they had missed one or more days of work or school because of their dizziness or balance problem.

        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. The vestibular and balance disorders are among the most common complaints that lead patients to visit their primary care physicians and are one of the most common reasons elderly people seek medical advice.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      References

      Additional resources about the objective

      1. Badke MB, Miedaner JA, Shea TA, et al. 2005. Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap. Ann Otol Rhinol Laryngol. 114(1 Pt 1):48–54.
      2. Cohen H, Kimball KT. 2000. Development of the vestibular disorders activities of daily living scale. Arch Otolaryngol Head Neck Surg. 126: 881–887.
      3. Hillier SL, Hollohan V. 2007. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. Oct 17;(4):CD005397.
  • ENT-VSL-15 Reduce the proportion of adults with balance and dizziness problems who have fallen and been injured

    • ENT-VSL-15.1 Reduce the proportion of adults with balance and dizziness problems who have fallen in the past 5 years while experiencing symptoms of dizziness, vertigo, or imbalance

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      55.6 (2008)
      Target: 
      50.0
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 18 years and over with dizziness or balance problems who have fallen in the past 5 years while having dizziness, vertigo, or imbalance just before or around the time they fell

      Denominator: 

      Number of adults (18+ years) with dizziness or balance problems in the past 12 months who have fallen in the past 5 years

      Comparable Healthy People 2010 Objective: 
      Not applicable
      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
        3. Refused
        4. Don't know

        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
        3. Refused
        4. Don't know
      • A floating, spacey, or tilting sensation
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling lightheaded, without a sense of motion
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling as if you are going to pass out or faint
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Blurring of your vision when you move your head
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling off-balance or unsteady
        1. Yes
        2. No
        3. Refused
        4. Don't know

        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
        7. Refused
        8. Don't know

        These next questions are about falls or falling. By falls or falling, we mean unexpectedly dropping to the floor or ground from a standing, walking or bending position.

        DURING THE PAST 5 YEARS, have you fallen at least one time?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        [NUMERATOR:]

        DURING THE PAST 5 YEARS, did any of your falls occur just before, or around the time.... Please say yes or no to each.

        • you were feeling a sense of spinning?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • you were having a floating or spacey feeling?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • you were feeling lightheaded?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • you were feeling like you are about to pass out?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • you were having blurred vision?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • you were having unsteadiness?
        1. Yes
        2. No
        3. Refused
        4. Don't know

        DURING THE PAST 12 MONTHS, have you fallen at least once a month on average?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        DURING THE PAST 12 MONTHS, how many times have you fallen?

        1. None
        2. 1 time
        3. 2 times
        4. 3-4 times
        5. 5-7 times
        6. 8 times
        7. Refused
        8. Don't know

        DURING THE PAST 12 MONTHS, did you have an injury as a result of a fall? For example, with a bruise, cut or wound, sprain, dislocation; fracture, broken bones, back pain, head or neck injury?

        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The denominator includes those persons who responded “yes” to having a problem with dizziness or balance in the past 12 months or “yes” to one or more of the six symptoms listed and “yes” to having fallen within the past 5 years. The numerator includes persons who responded “yes” to having a problem with dizziness or balance or “yes” to one or more of the six symptoms listed and "yes" to having fallen during the past 5 years AND who responded that they had experienced one of the six listed symptoms just before or around the time they had fallen.

        Dizziness and loss of balance are among the most common problems bringing patients to their doctor's office. As people get older, the onset of dizziness and falls from balance problems increases. These falls can lead to injury, hospitalization, surgery and even permanent disability. Every year, one-third to one-half of the population age 65 and over experience falls. Of all falls suffered by the elderly, about 50% are the result of vestibular problems. Complaints of dizziness and unsteadiness are frequent problems in accidental and job-related mild head injuries.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      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.
    • ENT-VSL-15.2 Reduce the proportion of adults with balance and dizziness problems who have been injured as a result of a fall for any reason in the past 12 months

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      No
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      41.7 (2008)
      Target: 
      37.5
      Target-Setting Method: 
      10 percent improvement
      Numerator: 

      Number of persons aged 18 years and over with dizziness or balance problems who have fallen and who were injured as a result of a fall in the past 12 months

      Denominator: 

      Number of persons aged 18 years and over with dizziness or balance problems and who have fallen in the past 12 months

      Comparable Healthy People 2010 Objective: 
      Not applicable
      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
        3. Refused
        4. Don't know

        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
        3. Refused
        4. Don't know
      • A floating, spacey, or tilting sensation
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling lightheaded, without a sense of motion
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling as if you are going to pass out or faint
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Blurring of your vision when you move your head
        1. Yes
        2. No
        3. Refused
        4. Don't know
      • Feeling off-balance or unsteady
        1. Yes
        2. No
        3. Refused
        4. Don't know

        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
        7. Refused
        8. Don't know

        [NUMERATOR:]

        DURING THE PAST 12 MONTHS, have you fallen at least once a month on average?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        DURING THE PAST 12 MONTHS, how many times have you fallen?

        1. None
        2. 1 time
        3. 2 times
        4. 3-4 times
        5. 5-7 times
        6. 8 times
        7. Refused
        8. Don't know

        DURING THE PAST 12 MONTHS, did you have an injury as a result of a fall? For example, with a bruise, cut or wound, sprain, dislocation; fracture, broken bones, back pain, head or neck injury?

        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
      Methodology Notes: 

        The denominator includes those persons who responded “yes” to having a problem with dizziness or balance in the past 12 months or “yes” to one or more of the six symptoms listed. The numerator includes persons who responded “yes” to having a problem with dizziness or balance or “yes” to one or more of the six symptoms AND who responded that they had fallen one or more times during the past 12 months and had had an injury as a result of a fall during the past 12 months.

        Dizziness and loss of balance are among the most common problems bringing patients to their doctor's office. Left untreated, the results can be debilitating. As people get older, the onset of dizziness and falls from balance problems increases. These falls can lead to injury, hospitalization, surgery and even permanent disability. The symptoms may include whirling dizziness, unsteadiness or imbalance when walking, and nausea. These symptoms may be mild, lasting only minutes, or severe, resulting in total disability.

        Many people experience increasing difficulty with balance and safe mobility as they age, which leads to the common and serious problem of falls. These problems are associated with loss of confidence and decreasing ability to function independently and can lead to the consideration of institutional care. Falls are also a major cause of death in the older population. Fortunately, most causes of falls and instability can be treated successfully, with improved mobility, and fall risk reduced. If treatment guidelines were adhered to, improved outcomes in community-dwelling older adults can be expected.

        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      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.
  • ENT-VSL-16 Increase the proportion of adults with chemosensory (smell or taste) disorders in the past 12 months who have ever seen a health care provider about their disorder

    About the Data

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

    Data Source: 
    National Health and Nutrition Examination Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent (age adjusted—see Comments)
    Baseline (Year): 
    18.5 (2011–14)
    Target: 
    Not applicable
    Target-Setting Method: 
    This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
    Numerator: 

    Number of adults aged 40 years and older with a smell or taste disorder in the past 12 months who reported ever seeing a health care provider about their smell or taste disorder

    Denominator: 

    Number of adults aged 40 years and older who reported having a smell or taste disorder during the past 12 months

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Data Collection Frequency: 
    Periodic
    Methodology Notes: 

      From the 2011-14 National Health and Nutrition Examination Survey:

      [NUMERATOR AND DENOMINATOR:]

      The next questions are about your sense of smell. During the past 12 months, have you had a problem with your ability to smell, such as not being able to smell things or things not smelling the way they are supposed to?

      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Do you sometimes smell an unpleasant, bad or burning odor when nothing is there?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • The next questions are about your sense of taste. During the past 12 months, have you had a problem with your ability to taste sweet, sour, salty or bitter foods and drinks?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • During the past 12 months have you had a taste or other sensation in your mouth that does not go away?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Have you ever discussed any problem with, or change in your ability to taste or smell with a health care provider? Including doctors, dentists, dietitians, and nutritionists as health care providers
      1. Yes
      2. No
      3. Refused
      4. Don't know

      [NUMERATOR:]

    • When was the last time you discussed any problem with your ability to taste or smell with a health care provider?
      1. IN THE PAST 12 MONTHS
      2. 1 TO 4 YEARS AGO
      3. 5 TO 9 YEARS AGO
      4. TEN OR MORE YEARS AGO
      5. Refused
      6. Don't know
      Age Adjustment Notes: 

      This Indicator uses Age-Adjustment Groups:

      • Total: 40-49, 50-59, 60-69, 70-79, 80+
      • Sex: 40-49, 50-59, 60-69, 70-79, 80+
      • Race/Ethnicity: 40-49, 50-59, 60-69, 70-79, 80+
      • Educational Attainment: 40-49, 50-59, 60-69, 70-79, 80+
      • Family Income (percent poverty threshold): 40-49, 50-59, 60-69, 70-79, 80+
      • Country of Birth: 40-49, 50-59, 60-69, 70-79, 80+
      • Disability Status: 40-49, 50-59, 60-69, 70-79, 80+
      • Health Insurance Status: 40-49, 50-59, 60-69, 70-79, 80+
      • Marital Status: 40-49, 50-59, 60-69, 70-79, 80+

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    The objective was moved from developmental to informational.
  • ENT-VSL-17 Increase proportion of adults with smell and taste disorders who have tried recommended methods of treating their smell or taste disorders to improve their condition in the past 12 months

    About the Data

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

    Data Source: 
    National Health and Nutrition Examination Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent (age adjusted—see Comments)
    Baseline (Year): 
    6.0 (2011–14)
    Target: 
    Not applicable
    Target-Setting Method: 
    This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
    Numerator: 

    Adults aged 40+ years who tried recommended methods of treating their smell or taste disorders to improve their condition in the past 12 months

    Denominator: 

    Adults aged 40+ years who have had smell or taste disorders in the past 12 months

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Questions Used to Obtain the National Baseline Data: 

      From the 2011-14 National Health and Nutrition Examination Survey:

      [NUMERATOR AND DENOMINATOR:]

      During the past 12 months, have you had a problem with your ability to smell, such as not being able to smell things or things not smelling the way they are supposed to?

      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Do you sometimes smell an unpleasant, bad or burning odor when nothing is there?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • During the past 12 months, have you had a problem with your ability to taste sweet, sour, salty or bitter foods and drinks?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • During the past 12 months have you had a taste or other sensation in your mouth that does not go away?
      1. Yes
      2. No
      3. Refused
      4. Don't know

      [NUMERATOR:]

    • During the past 12 months, have you tried any treatments to improve your ability to taste or smell?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
      Age Adjustment Notes: 

      This Indicator uses Age-Adjustment Groups:

      • Total: 40-49, 50-59, 60-69, 70-79, 80+
      • Sex: 40-49, 50-59, 60-69, 70-79, 80+
      • Race/Ethnicity: 40-49, 50-59, 60-69, 70-79, 80+
      • Educational Attainment: 40-49, 50-59, 60-69, 70-79, 80+
      • Family Income (percent poverty threshold): 40-49, 50-59, 60-69, 70-79, 80+
      • Country of Birth: 40-49, 50-59, 60-69, 70-79, 80+
      • Disability Status: 40-49, 50-59, 60-69, 70-79, 80+
      • Health Insurance Status: 40-49, 50-59, 60-69, 70-79, 80+
      • Marital Status: 40-49, 50-59, 60-69, 70-79, 80+

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    The objective was moved from developmental to informational.
  • ENT-VSL-18 Reduce the proportion of adults with chemosensory (smell or taste) disorders who as a result have experienced a negative impact on their general health status, work, or quality of life in the past 12 months

    About the Data

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

    Data Source: 
    National Health and Nutrition Examination Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent
    Baseline (Year): 
    4.7 (2011–14)
    Target: 
    Not applicable
    Target-Setting Method: 
    This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
    Numerator: 

    Adults aged 40+ years with chemosensory (smell or taste) disorders who have experienced a negative impact on their general health status, work, or quality of life in the past 12 months as a result of their condition

    Denominator: 

    Adults aged 40+ who have had a smell or taste disorders in past 12 months

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Questions Used to Obtain the National Baseline Data: 

      From the 2011-14 National Health and Nutrition Examination Survey:

      [NUMERATOR AND DENOMINATOR:]

      During the past 12 months, have you had a problem with your ability to smell, such as not being able to smell things or things not smelling the way they are supposed to?

      1. Yes
      2. No
      3. Refused
      4. Don't know
    • Do you sometimes smell an unpleasant, bad or burning odor when nothing is there?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • During the past 12 months, have you had a problem with your ability to taste sweet, sour, salty or bitter foods and drinks?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • During the past 12 months have you had a taste or other sensation in your mouth that does not go away?
      1. Yes
      2. No
      3. Refused
      4. Don't know

      [NUMERATOR:]

    • During the past 12 months, have you experienced a problem with your general health, work or your enjoyment of life because of a problem with your ability to taste or smell?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
    Methodology Notes: 

      This Indicator uses Age-Adjustment Groups:

      • Total: 40-49, 50-59, 60-69, 70-79, 80+
      • Sex: 40-49, 50-59, 60-69, 70-79, 80+
      • Race/Ethnicity: 40-49, 50-59, 60-69, 70-79, 80+
      • Educational Attainment: 40-49, 50-59, 60-69, 70-79, 80+
      • Family Income (percent poverty threshold): 40-49, 50-59, 60-69, 70-79, 80+
      • Country of Birth: 40-49, 50-59, 60-69, 70-79, 80+
      • Disability Status: 40-49, 50-59, 60-69, 70-79, 80+
      • Health Insurance Status: 40-49, 50-59, 60-69, 70-79, 80+
      • Marital Status: 40-49, 50-59, 60-69, 70-79, 80+

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    The objective was moved from developmental to informational.
  • ENT-VSL-19 Increase the proportion of persons with communication disorders of voice, swallowing, speech, or language who have seen a speech-language pathologist (SLP) for evaluation or treatment

    About the Data

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

    Data Source: 
    National Health Interview Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent (age adjusted—see Comments)
    Baseline (Year): 
    12.8 (2012)
    Target: 
    Not applicable
    Target-Setting Method: 
    This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
    Numerator: 

    Adults aged 18+ years with communication disorders of voice, swallowing, speech, or language who have seen a speech-language pathologist for evaluation or treatment in the past 12 months

    Denominator: 

    Adults aged 18+ with communication disorders of voice, swallowing, speech, or language in the past 12 months

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Questions Used to Obtain the National Baseline Data: 

      From the 2012 National Health Interview Survey:

      [NUMERATOR AND DENOMINATOR:]

      DURING THE PAST 12 MONTHS, have you had any problems or difficulties with your VOICE, such as having a hoarse, raspy, or strained voice, or with difficulty speaking loud enough to be heard?

      1. Yes
      2. No
      3. Refused
      4. Don't know
    • DURING THE PAST 12 MONTHS, have you had a SWALLOWING problem, such as difficulty eating solid food, taking pills, or drinking beverages?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • DURING THE PAST 12 MONTHS, have you had a SPEECH problem, such as stuttering, repeating words, or not being able to pronounce words properly?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • DURING THE PAST 12 MONTHS, have you had a LANGUAGE problem, such as problems using or understanding words or sentences?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • How many days in the past year did you have voice problems?
      1. 1-365
      2. Refused
      3. Don't know
    • How many days in the past year did you have problems swallowing?
      1. 1-365
      2. Refused
      3. Don't know
    • How many days in the past year did you have speech problems?
      1. 1-365
      2. Refused
      3. Don't know
    • How many days in the past year did you have problems using or understanding words or sentences?
      1. 1-365
      2. Refused
      3. Don't know

      Altogether, did your voice problems last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your problems swallowing last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your speech problems last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your problems using or understanding words or sentences last for a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      [NUMERATOR:]

    • DURING THE PAST 12 MONTHS, have you seen a speech-language pathologist (SLP) or other health care professional about your voice problems?
      1. Yes
      2. No
      3. Refused
      4. Don't know

      DURING THE PAST 12 MONTHS, have you seen a speech-language pathologist (SLP) or other health care professional about your problems swallowing?

      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you seen a speech-language pathologist (SLP) or other health care professional about your speech problems?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you seen a speech-language pathologist (SLP) or other health care professional about your problems using or understanding words or sentences?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
      Age Adjustment Notes: 

      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 (percent poverty threshold): 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+

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    The objective was moved from developmental to informational.
  • ENT-VSL-20 Increase the proportion of persons with communication disorders of voice, swallowing, speech, or language who have participated in rehabilitation services

    About the Data

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

    Data Source: 
    National Health Interview Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent (age adjusted—see Comments)
    Baseline (Year): 
    11.7 (2012)
    Target: 
    Not applicable
    Target-Setting Method: 
    This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
    Numerator: 

    Adults aged 18+ years with communication disorders of voice, swallowing, speech, or language who have participated in rehabilitation services in the past 12 months

    Denominator: 

    Adults aged 18+ years who have had a communication disorders of voice, swallowing, speech, or language in the past 12 months

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Questions Used to Obtain the National Baseline Data: 

      From the 2012 National Health Interview Survey:

      [NUMERATOR AND DENOMINATOR:]

      DURING THE PAST 12 MONTHS, have you had any problems or difficulties with your VOICE, such as having a hoarse, raspy, or strained voice, or with difficulty speaking loud enough to be heard?

      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you had a SWALLOWING problem, such as difficulty eating solid food, taking pills, or drinking beverages?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you had a SPEECH problem, such as stuttering, repeating words, or not being able to pronounce words properly?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you had a LANGUAGE problem, such as problems using or understanding words or sentences?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    • How many days in the past year did you have voice problems?
      1. 1-365
      2. Refused
      3. Don't know

    • How many days in the past year did you have problems swallowing?
      1. 1-365
      2. Refused
      3. Don't know

    • How many days in the past year did you have speech problems?
      1. 1-365
      2. Refused
      3. Don't know

    • How many days in the past year did you have problems using or understanding words or sentences?
      1. 1-365
      2. Refused
      3. Don't know

      Altogether, did your voice problems last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your problems swallowing last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your speech problems last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your problems using or understanding words or sentences last for a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      [NUMERATOR:]

    • DURING THE PAST 12 MONTHS, have you received treatments, therapy, or other rehabilitation services for your voice problems?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you received treatments, therapy, or other rehabilitation services for your problems swallowing?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you received treatments, therapy, or other rehabilitation services for your speech problems?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you received treatments, therapy, or other rehabilitation services, for your problems using or understanding words or sentences?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
      Age Adjustment Notes: 

      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 (percent poverty threshold): 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+

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    The objective was moved from developmental to informational.
  • ENT-VSL-21 Increase the proportion of young children with phonological disorders, language delay, or other developmental language problems who have participated in speech-language or other intervention services

    About the Data

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

    Data Source: 
    National Health Interview Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent
    Baseline (Year): 
    59.7 (2012)
    Target: 
    Not applicable
    Target-Setting Method: 
    This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
    Numerator: 

    Number of children aged 3 to 17 years with communication disorders of voice, speech, or language during the past 12 months who participated in speech-language or other intervention services

    Denominator: 

    Number of children aged 3 to 17 years with communications disorders of voice, speech, or language during the past 12 months

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Questions Used to Obtain the National Baseline Data: 

      From the 2012 National Health Interview Survey:

      [NUMERATOR AND DENOMINATOR:]

      DURING THE PAST 12 MONTHS, has your child had any problems or difficulties with his/her VOICE, such as too weak, hoarse, or strained that lasted for a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, has your child had a problem speaking, such as making speech sounds correctly or stuttering that lasted for a week or longer?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, has your child had a problem learning, using, or understanding words or sentences that lasted for a week or longer?
      1. Yes
      2. No
      3. Refused
      4. Don't know

      [NUMERATOR:]

    • DURING THE PAST 12 MONTHS, did your child receive speech language therapy or other intervention services for his/her voice problems?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, did your child receive speech language therapy or other intervention services for his/her speech problems?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, did your child receive speech language therapy or other intervention services for his/her problems using, learning or understanding words or sentences?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    The objective was moved from developmental to informational.
  • ENT-VSL-22 Increase the proportion of persons with communication disorders of voice, swallowing, speech, or language in the past 12 months whose personal or social functioning at home, school, or work improved after participation in speech-language therapy or other rehabilitative or intervention services

    About the Data

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

    Data Source: 
    National Health Interview Survey
    Changed Since the Healthy People 2020 Launch: 
    Yes
    Measure: 
    percent (age adjusted—see Comments)
    Baseline (Year): 
    71.5 (2012)
    Target: 
    Not applicable
    Target-Setting Method: 
    This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
    Numerator: 

    Adults aged 18+ years with communication disorders of voice, swallowing, speech, or language in the past 12 months whose personal or social functioning at home, school, or work improved after participation in speech-language therapy or other rehabilitative or intervention services

    Denominator: 

    Adults aged 18+ who have a communication disorders of voice, swallowing, speech, or language who have participated in rehabilitation services in the past 12 months

    Comparable Healthy People 2010 Objective: 
    Not applicable
    Questions Used to Obtain the National Baseline Data: 

      From the 2012 National Health Interview Survey:

      [NUMERATOR AND DENOMINATOR:]

      DURING THE PAST 12 MONTHS, have you had any problems or difficulties with your VOICE, such as having a hoarse, raspy, or strained voice, or with difficulty speaking loud enough to be heard?

      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you had a SWALLOWING problem, such as difficulty eating solid food, taking pills, or drinking beverages?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you had a SPEECH problem, such as stuttering, repeating words, or not being able to pronounce words properly?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • DURING THE PAST 12 MONTHS, have you had a LANGUAGE problem, such as problems using or understanding words or sentences?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • How many days in the past year did you have voice problems?
      1. 1-365
      2. Refused
      3. Don't know

    • How many days in the past year did you have problems swallowing?
      1. 1-365
      2. Refused
      3. Don't know

    • How many days in the past year did you have speech problems?
      1. 1-365
      2. Refused
      3. Don't know

    • How many days in the past year did you have problems using or understanding words or sentences?
      1. 1-365
      2. Refused
      3. Don't know

      Altogether, did your voice problems last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your problems swallowing last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your speech problems last a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      Altogether, did your problems using or understanding words or sentences last for a week or longer?

      1. Yes
      2. No
      3. Refused
      4. Don't know

      [NUMERATOR:]

    • Did the treatments or other rehabilitation services for your voice problems make your personal or social life better?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • Did the treatments or other rehabilitation services for your problems swallowing make your personal or social life better?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • Did the treatments or other rehabilitation services for your speech problems make your personal or social life better?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • Did the treatments or other rehabilitation services for your problems using or understanding words or sentences make your personal or social life better?
      1. Yes
      2. No
      3. Refused
      4. Don't know

    • Did the treatments or other rehabilitation services for your voice problems make your life at school or work better?
      1. Yes
      2. No
      3. Refused
      4. Don't know
    Data Collection Frequency: 
    Periodic
      Age Adjustment Notes: 

      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 (percent poverty threshold): 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+

    Revision History

    Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

    Description of Changes Since the Healthy People 2020 Launch: 
    The objective was moved from developmental to informational.
  • ENT-VSL-23 Increase the proportion of persons with hearing loss and other communication disorders who have used Internet resources for health care information, guidance, or advice in the past 12 months

    • ENT-VSL-23.1 Increase the proportion of persons with communication disorders of voice, swallowing, speech, or language who have used Internet resources for health care information, guidance, or advice in the past 12 months

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      Yes
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      31.9 (2012)
      Target: 
      Not applicable
      Target-Setting Method: 
      This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
      Numerator: 

      Number of adults aged 18+ years and older with communication disorders of voice, swallowing, speech, or language who have used Internet resources for health care information, guidance, or advice in the past 12 months

      Denominator: 

      Number of adults aged 18+ years and older with communication disorders of voice, swallowing, speech, or language

      Comparable Healthy People 2010 Objective: 
      Not applicable
      Questions Used to Obtain the National Baseline Data: 

        From the 2012 National Health Interview Survey:

        [NUMERATOR AND DENOMINATOR:]

        DURING THE PAST 12 MONTHS, have you had any problems or difficulties with your VOICE, such as having a hoarse, raspy, or strained voice, or with difficulty speaking loud enough to be heard?

        1. Yes
        2. No
        3. Refused
        4. Don't know

      • DURING THE PAST 12 MONTHS, have you had a SWALLOWING problem, such as difficulty eating solid food, taking pills, or drinking beverages?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • DURING THE PAST 12 MONTHS, have you had a SPEECH problem, such as stuttering, repeating words, or not being able to pronounce words properly?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • DURING THE PAST 12 MONTHS, have you had a LANGUAGE problem, such as problems using or understanding words or sentences?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • How many days in the past year did you have voice problems?
        1. 1-365
        2. Refused
        3. Don't know

      • How many days in the past year did you have problems swallowing?
        1. 1-365
        2. Refused
        3. Don't know

      • How many days in the past year did you have speech problems?
        1. 1-365
        2. Refused
        3. Don't know

      • How many days in the past year did you have problems using or understanding words or sentences?
        1. 1-365
        2. Refused
        3. Don't know

        Altogether, did your voice problems last a week or longer?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        Altogether, did your problems swallowing last a week or longer?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        Altogether, did your speech problems last a week or longer?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        Altogether, did your problems using or understanding words or sentences last for a week or longer?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        [NUMERATOR:]

      • DURING THE PAST 12 MONTHS, did you get information from the Internet on Voice problems, Problems swallowing, Speech problems, or Problems using or understanding words or sentences?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      Revision History

      Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

      Description of Changes Since the Healthy People 2020 Launch: 
      The original objective (ENT-VSL-23) was to “Increase the proportion of persons with hearing loss and other communication disorders who have used Internet resources for health care information, guidance, or advice in the past 12 months.” In 2019, this objective was moved from developmental to informational and was split into three measures because the data to track different mission areas come from three different surveys. ENT-VSL-23.1 monitors the proportion of persons with communication disorders of voice, swallowing, speech, or language who have used Internet resources for health care information, guidance, or advice in the past 12 months; ENV-VSL-23.2 monitors the proportion of persons with moderate or worse hearing loss, moderate or worse tinnitus, or have hearing aids, cochlear implants, or other assistive listening devices who have used Internet resources for health care information, guidance, or advice about their hearing-related disorders in the past 12 months; and ENT-VSL-23.3 monitors the proportion of persons with balance and vestibular disorders who have used Internet resources for health care information, guidance, or advice about their balance disorder in the past 12 months.
    • ENT-VSL-23.2 Increase the proportion of persons with moderate or worse hearing loss, moderate or worse tinnitus, or having hearing aids, cochlear implants, or other assistive listening devices who have used Internet resources for health care information, guidance, or advice about their hearing-related disorders in the past 12 months

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      Yes
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      9.2 (2014)
      Target: 
      Not applicable
      Target-Setting Method: 
      This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
      Numerator: 

      Number of adults aged 18+ years with moderate or worse hearing loss, tinnitus, or hearing aids (including cochlear implants or other devices) who have used Internet resources for health care information, guidance, or advice in the past 12 months

      Denominator: 

      Number of adults aged 18+ years with moderate or worse hearing loss, tinnitus, or hearing aids (including cochlear implants or other devices)

      Questions Used to Obtain the National Baseline Data: 

        From the 2014 National Health Interview Survey:

        [NUMERATOR AND DENOMINATOR:]

        Is your hearing excellent, good, a little trouble hearing, moderate trouble, a lot of trouble, or are you deaf?

        1. EXCELLENT
        2. GOOD
        3. A LITTLE TROUBLE HEARING
        4. MODERATE TROUBLE
        5. A LOT OF TROUBLE
        6. DEAF
        7. REFUSED
        8. DON’T KNOW

      • DURING THE PAST 12 MONTHS, have you been bothered by ringing, roaring, or buzzing in your ears or head that lasts for 5 minutes or more?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • How much of a problem is this ringing, roaring, or buzzing in your ears or head? Would you say it is…
        1. NO PROBLEM
        2. A SMALL PROBLEM
        3. A MODERATE PROBLEM
        4. A BIG PROBLEM
        5. A VERY BIG PROBLEM
        6. REFUSED
        7. DON’T KNOW

      • Have you had cochlear implant surgery?
        1. Yes
        2. No
        3. Refused
        4. Don't know

        Do you now use a hearing aid(s)?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        Have you ever used a hearing aid(s) in the past?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        BECAUSE OF YOUR HEARING, have you ever used assistive technology to communicate, such as FM systems, instant or text messages, headsets, closed-caption television, amplified telephone, relay services, or live video streaming?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        [NUMERATOR:]

      • DURING THE PAST 12 MONTHS, did you get information from the internet about your health, medical treatments, or rehabilitation services?
        1. Yes
        2. No
        3. Refused
        4. Don't know

        DURING THE PAST 12 MONTHS, did you or others get information from the internet on Hearing loss for you?

        1. Yes
        2. No
        3. Refused
        4. Don't know
      • DURING THE PAST 12 MONTHS, did you or others get information from the internet on Hearing aids, including cochlear implants or other devices for you?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • DURING THE PAST 12 MONTHS, did you or others get information from the internet on Ringing, roaring, or buzzing sounds in the ears or head (tinnitus) for you?
        1. Yes
        2. No
        3. Refused
      Data Collection Frequency: 
      Periodic
        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      Revision History

      Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

      Description of Changes Since the Healthy People 2020 Launch: 
      The original objective (ENT-VSL-23) was to “Increase the proportion of persons with hearing loss and other communication disorders who have used Internet resources for health care information, guidance, or advice in the past 12 months.” In 2019, this objective was moved from developmental to informational and was split into three measures because the data to track different mission areas come from three different surveys. ENT-VSL-23.1 monitors the proportion of persons with communication disorders of voice, swallowing, speech, or language who have used Internet resources for health care information, guidance, or advice in the past 12 months; ENV-VSL-23.2 monitors the proportion of persons with moderate or worse hearing loss, moderate or worse tinnitus, or have hearing aids, cochlear implants, or other assistive listening devices who have used Internet resources for health care information, guidance, or advice about their hearing-related disorders in the past 12 months; and ENT-VSL-23.3 monitors the proportion of persons with balance and vestibular disorders who have used Internet resources for health care information, guidance, or advice about their balance disorder in the past 12 months.
    • ENT-VSL-23.3 Increase the proportion of persons with balance and vestibular disorders who have used Internet resources for health care information, guidance, or advice in the past 12 months

      About the Data

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

      Data Source: 
      National Health Interview Survey
      Changed Since the Healthy People 2020 Launch: 
      Yes
      Measure: 
      percent (age adjusted—see Comments)
      Baseline (Year): 
      20.3 (2016)
      Target: 
      Not applicable
      Target-Setting Method: 
      This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
      Numerator: 

      Number of adults aged 18+ years with balance and vestibular disorders who have used Internet resources for health care information, guidance, or advice in the past 12 months

      Denominator: 

      Number of adults aged 18+ years with balance and vestibular disorders during the past 12 months

      Comparable Healthy People 2010 Objective: 
      Not applicable
      Questions Used to Obtain the National Baseline Data: 

        From the 2016 National Health Interview Survey:

        [NUMERATOR AND DENOMINATOR:]

      • Have you EVER had a problem with dizziness, lightheadedness, feeling as if you are going to pass out or faint, or with unsteadiness or feeling off-balance? Do not include times when drinking alcohol?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • 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
        3. Refused
        4. Don't know

        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 or other illusion of motion such as tipping, tilting, or rocking?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        ... A floating, spacey, or disconnected sensation?

        1. Yes
        2. No
        3. Refused
        4. Don't know

        Feeling lightheaded, without a sense of motion?

        1. Yes
        2. No
        3. Refused
        4. Don't know

      • Feeling as if you are going to pass out or faint?
        1. Yes
        2. No
        3. Refused
        4. Don't know

        Blurring of your vision when you move your head?

        1. Yes
        2. No
        3. Refused
        4. Don't know

      • Feeling off-balance or unsteady?
        1. Yes
        2. No
        3. Refused
        4. Don't know

        DURING THE PAST 12 MONTHS, which ONE of these feelings of dizziness or balance problems bothered you the most?

        1. THE SPINNING, VERTIGO, OR MOTION SENSATION
        2. THE FLOATING, SPACEY, OR DISCONNECTED FEELING
        3. THE FEELING OF LIGHTHEADEDNESS
        4. THE FEELING LIKE YOU ARE ABOUT TO PASS OUT
        5. BLURRED VISION
        6. UNSTEADINESS
        7. OTHER DIZZINESS OR BALANCE PROBLEM
        8. REFUSED
        9. DON’T KNOW

        [NUMERATOR:]

      • DURING THE PAST 12 MONTHS, have you used the Internet for any of the following reasons?
        ... To look up health information on your dizziness or balance problems?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • To learn about medical or other recommended treatments for your dizziness or balance problems?
        1. Yes
        2. No
        3. Refused
        4. Don't know

      • To learn about rehabilitation services or intervention programs for your dizziness or balance problems?
        1. Yes
        2. No
        3. Refused
        4. Don't know
      Data Collection Frequency: 
      Periodic
        Age Adjustment Notes: 

        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 (percent poverty threshold): 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+

      Revision History

      Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

      Description of Changes Since the Healthy People 2020 Launch: 
      The original objective (ENT-VSL-23) was to “Increase the proportion of persons with hearing loss and other communication disorders who have used Internet resources for health care information, guidance, or advice in the past 12 months.” In 2019, this objective was moved from developmental to informational and was split into three measures because the data to track different mission areas come from three different surveys. ENT-VSL-23.1 monitors the proportion of persons with communication disorders of voice, swallowing, speech, or language who have used Internet resources for health care information, guidance, or advice in the past 12 months; ENV-VSL-23.2 monitors the proportion of persons with moderate or worse hearing loss, moderate or worse tinnitus, or have hearing aids, cochlear implants, or other assistive listening devices who have used Internet resources for health care information, guidance, or advice about their hearing-related disorders in the past 12 months; and ENT-VSL-23.3 monitors the proportion of persons with balance and vestibular disorders who have used Internet resources for health care information, guidance, or advice about their balance disorder in the past 12 months.