Hygiena 2008, 53(2):40-47
Response and Non-response in the Czech Population Health Survey (Results of the HELEN Study)
- Státní zdravotní ústav, Praha
- 1 Centrum hygieny životního prostředí
- 2 Oddělení biostatistiky a informatiky
Response rates are one of important markers to influence the validity of epidemiological studies, including selective surveys of population health. One of selective surveys performed in the Czech Republic is the questionnaire-based survey - the "HELEN study". The HELEN study is a part of the System of Monitoring of Health of the Population related to the environment. The overall response rate of the study decreased from 70 % in the first stage (1998-2002) to 50 % in the second stage (2004-2005). The lower response rate was due to decreasing willingness in Czech society to participate in similar surveys and was also influenced by the performance of researchers in several cities.
Part of the methodology of the second stage of the HELEN study included a questionnaire for non-respondents with questions about their education, current economic activity and subjective health evaluation. In total, data from 884 (9.4 %) nonrespondents were obtained. Data from 13 cities (total of 809 non-respondents) were included in the statistical evaluation with more than 20 completed forms per city. Comparison of differences between respondents and non-respondents was made using the Mantel-Haenszel test. No significant differences were found in the representation of males and females. Non-respondents included significantly more unemployed persons. Also, persons with lower education and worse subjective health evaluation were more likely to be non-respondents, but these differences were not statistically significant. Non-respondents included a higher ratio of persons with both very good and very bad health evaluation (greater extremes) as well as a lower ratio of persons with average health evaluation. The majority of significant differences in achieved education were found between respondents and non-respondents in the categories of elementary and university education, while university graduates were significantly less likely to be non-respondents. Our results suggest a worse socio-economic situation among non-respondents compared to respondents. We therefore assume poorer lifestyle and subjective health evaluation in non-respondents.
In the next stage of the HELEN study it will be necessary to improve the accuracy of the methodology related to non-respondency including the necessity of obtaining respondent data and maintenance of accurate records during field work. It will also be necessary to consider other options for increasing response rate.
Keywords: health study, response rate, non-respondents
Published: June 2008 Show citation
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