Miami Herald - January 12, 2007
Jacob Goldstein, jgoldstein@MiamiHerald.com

Today, a procession of Miamians will begin filing into a mobile clinic set up in four semi-trailers in a parking lot on the main campus of Florida International University in West Miami-Dade. Each person will undergo three or four hours of prodding and questioning as researchers record everything from their lung capacity to what they ate for breakfast.

The prodding and questioning are part of NHANES, the National Health and Nutrition Examination Survey, a federally funded, never-ending tour that provides a broad data set on the nation's health. For the past several years, researchers tried to recruit a survey population that was one-third black, one-third Mexican American and one-third everyone else. Beginning this year, they will aim for a population that is one-third non-Hispanic black, one-third Hispanic and one-third everyone else.

"There are so many other Hispanic groups that are so important to study that we felt that we really need to broaden our sampling," said Dr. Kathryn Porter, one of the survey's leaders.

The shift is part of a larger trend of health researchers paying more attention to Hispanics in America -- and recognizing that there may be variations within the Hispanic community itself.

The health of the Hispanic community "is not really well understood," said Dr. Neil Schneiderman, a University of Miami researcher who is heading up the Miami site for another federally funded study examining Hispanic health. "They fall into somewhat discrete [groups]: Puerto Rican, Cuban, Mexican American, and South and Central Americans."

In general, Hispanics fare better than average on key health indicators like infant mortality and life expectancy, despite having less access to care and lower socioeconomic status. On the other hand, Hispanics have higher rates of HIV, diabetes and obesity.

Most research has focused on Mexican Americans, who comprise the majority of American Hispanics. Data that allows researchers to distinguish between different groups of Hispanics remains scarce.

NHANES, which began in the 1960s, has three survey teams on the road at all times, and they examine about 5,000 people per year. At that rate, Porter said, it will be several years before NHANES surveys enough people to create good data on the health trends of different Hispanic groups.

Who exactly will be recruited is guided largely by computers, which use census data and guidelines created by NHANES researchers to select counties, neighborhoods and households. Field workers began visiting neighborhoods in Miami-Dade late last year. By the time the Miami project is done late next month, they will have knocked on roughly 1,000 doors in order to recruit 300 people to be examined, said NHANES spokeswoman Nora Martinello.

Each examination lasts several hours and includes interviews as well as tests of the eyes, ears, blood, urine, lungs and bones. The data gives researchers a clear picture of national averages and allows them to see how health factors vary with race, gender and ethnicity as well as how the picture changes over time.

Results from the survey contributed to the decision to ban leaded gasoline and helped illuminate the relationship between cholesterol and heart disease. "It's very rigorous," said Dr. Earl Fox, a University of Miami epidemiologist who is not affiliated with NHANES. "It's data you can hang your hat on."

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