Appendix XI. Examination Protocol Deviations From Life Insurance Examination Protocols

Adena M. Galinsky; Grace E. Medley; Duong T. Nguyen; Maria A. Villarroel; Antonia Warren; Benjamin Zablotsky; Eric Leadbetter; Aaron Maitland

Appendix XI. Examination Protocol Deviations From Life Insurance Examination Protocols

The blood pressure and body measurement components of the National Health Interview Survey Follow-up Health Study home visit followed the protocols for life insurance paramedical examinations, with slight modifications to the height and waist circumference measurements. The Table describes the nature and reason for those modifications.

Table

Comparison of protocols for measuring height and waist circumference: Life insurance paramedical examination and National Health Interview Survey Follow-up Health Study home visit

Publication Details

Copyright

All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Publisher

National Center for Health Statistics (NCHS), Atlanta (GA)

NLM Citation

Galinsky AM, Medley GE, Nguyen DT, et al. National Health Interview Survey Follow-up Health Study: Feasibility Evaluation of Adding an In-home Physical Examination to a National Health Survey [Internet]. Atlanta (GA): National Center for Health Statistics (NCHS); 2024 Dec. Appendix XI. Examination Protocol Deviations From Life Insurance Examination Protocols.

Table

Comparison of protocols for measuring height and waist circumference: Life insurance paramedical examination and National Health Interview Survey Follow-up Health Study home visit

Measurement	Life insurance protocol	NHIS Follow-up Health Study protocol	Reason for modifying life insurance protocol
Height	Measurements are taken from the bottom of the participant’s foot to the top of the participant’s head. The participant remains standing against the wall when recording the measurement. One measurement is recorded in inches, to the nearest inch.	The measurements were taken from the floor to a sticky note that was placed on the wall alongside the straightedge placed on top of the participant’s head. The participant stepped away from the wall while the health representative used the tape measure to measure the distance from the floor to the sticky note. One measurement was recorded in inches to the nearest half-inch.	NHIS FHS used the protocol that ExamOne typically uses in their research studies. The height measurement was measured to the nearest half-inch to match the reported body mass index format in the report of findings, which was to the nearest 0.1.
Waist circumference	Body mass index is a poor measurement of true obesity because muscle weight is not considered in the calculation, which includes only height and weight. For this reason, the life insurance industry guideline is to take chest and waist measurements on males only to get a better understanding of body mass index. The waist measurement is taken by the examiner, who wraps the measuring tape around the participant at the level of the umbilicus, with the abdomen relaxed and the measuring tape at the same level front and back. One measurement is taken in inches to the nearest inch.	The measurement was taken on male and female participants. The measurement was taken by having the participant hold the zero end of the tape measure at the umbilicus and turning 360 degrees while the health representative held the other end of the tape measure. The health representative then recorded the measurement where the two ends of the tape measure met. One measurement was taken in inches to the nearest half-inch.	Because the follow-up study required that waist circumference be taken on both males and females, ExamOne recommended that the protocol be modified to avoid having the health representative place their arms around the participant’s waist. The weight measurement was measured to the nearest half-inch to match the reported body mass index format in the report of findings, which was to the nearest 0.1.

: SOURCE: National Center for Health Statistics, National Health Interview Survey Follow-up Health Study, 2021.