by Lucinda Cave, MSN, RN, BC ONA Member
Nurses improve other people’s health in many ways – our care, our teaching, and the role modeling of healthy behaviors ourselves (what this blog is all about!) – but one way nurses have made a significant impact on everyone’s health is by participating in the Nurses’ Health Study (NHS).
And what is the Nurses’ Health Study? Or actually, Nurses’ Health Studies?
They are the longest running investigations of women’s health in the world! The Nurses’ Health Studies are frequently cited in both professional and lay literature, in the U.S. and world-wide, as the source of much of what we know about best health practices. Think of it . . . Healthy Nurses contribute the best information known about what makes people healthy!
Although there were some earlier surveys, the original Nurses’ Health Study began in 1976 with 122,000 nurses, 90% of whom still participate. Nurses’ Health Study II began in 1989, and recruitment for the third generation is taking place right now (Click http://www.nhs3.org/ for enrollment information).
To honor NHS’ 40th birthday, and the 238,000 nurses who have participated, The September, 2016 issue of American Journal of Public Health is devoted to the studies and their findings. (September issue is no longer the “Current Issue”, but may be accessed from Lower Right picture on the screen.)
Here are just a few of the ways Healthy Nurses have contributed to what we know about good health:
- Found that weight gain and being overweight or obese are important risk factors for type 2 diabetes, cardiovascular diseases, certain types of cancers, and premature death.
- Provided compelling evidence that the majority of vascular events may be prevented by avoiding smoking, participating in regular physical activity, maintaining normal body mass index, and eating a healthy diet.
- Recognized groundbreaking evidence that foods containing trans fat are particularly harmful
- Led to understanding of the dietary causes of various diseases
- Found that women with low to moderate alcohol intake and regular frequency (> 3 days/week) had the lowest risk of mortality compared with abstainers and women who consumed substantially more than 1 drink per day.
- Contributed to our understanding of lifestyle, hormonal, and genetic risk factors for breast cancer, and helped identify lifestyle changes that may reduce risk and improve survival after a diagnosis of breast cancer.
- Provided new insights into colorectal adenomas, etiology, and pathogenic mechanisms.
- Contributed to prevention and improved survival from less common malignancies - endometrial, ovarian, pancreatic, and hematologic cancers.
- Contributed to our understanding of the complex relationship between exogenous hormones and health outcomes in women.
- Reported first that higher dietary calcium was associated with a lower risk of kidney stones in women.
- Uncovered important roles in type 2 diabetes for individual nutrients, foods, dietary patterns, and physical activity, independent of excess body weight. Up to 90% of type 2 diabetes cases are potentially preventable if individuals follow a healthy diet and lifestyle.
- Made major contributions to public health recommendations and strategies designed to reduce the global burden of diabetes.
- Produced novel and influential research on the interplay of psychological and social factors with health.
- Found that higher intake of nuts, moderate alcohol consumption, and higher physical activity levels were associated with better cognitive function.
- Provided invaluable resources on skin disease population science and contributed to the etiological understanding of multiple skin disorders.
- Enabled the evaluation of gene–environment interactions.
- Addressed questions regarding long-term health consequences of pregnancy complications and benign gynecologic conditions on chronic disease risk.
- Supported public health recommendations for helping to prevent age-related eye diseases: abstinence from cigarette smoking, maintenance of healthy weight and diabetes prevention, and a healthy diet rich in fruits and vegetables.
Quite the impact!
Just how does the NHS accomplish all of this? Nurse participants complete detailed surveys every two years, then various subsets are asked to provide additional information and samples. How do I know? Well . . .the ink was barely dry on my first nursing license (Yes. We used to have printed license cards.) when I received a letter requesting my participation. I completed the first survey (hard copy, number 2 pencil, bubble sheets . . . ) and have been doing so ever since.
Like everything else, the NHS surveys are now online, and take less than a half hour to complete. Focus of the mass survey differs each time, but all are about some aspect of health. Nurses were likely chosen as subjects because of our education, familiarity with the topics, and desire to promote healthy behaviors. We’ll take the time to provide honest answers. Face it; we’re trusted. We won’t under-report our weight, or over-report our exercise time . . . or tend not to. I racked my brain mercilessly for one nutrition-based survey, trying to be as accurate as possible. Who counts how many apricots she eats every month, or Brazil nuts, or servings of lentil beans . . . ?
Occasionally, subjects are asked to participate in additional studies. This has led to some interesting situations – such as being hooked up to a continuous blood pressure monitor for a couple of days. Every time things would get quiet at work, the blood pressure motor would begin to pump and whir. Science!
It’s also true that some of the special studies are age-related. In my earlier NHS years, they asked about how I was fed as an infant, and my contraception and reproductive history. Later, they involved one of my children in their Growing up Today Study (GUTS). However, now they’ve enrolled me in a special arm, studying memory loss and mental status changes. I guess I know what that’s saying – upper end of the age spectrum! At least the required computer games for that one are fun to play (when I remember to log in - after a few reminders).
Seriously though, it is an honor and a privilege to be involved with something as important as NHS, to contribute in one very small way to the good health of people here and around the world. (Yes. NHS results have world-wide exposure.)
Perhaps many ONA members are involved since Ohio was one of the initial states targeted for enrollment. Please share any comments, anecdotes, or experiences you have had with NHS participation. Reply in ‘Comments’.
It is also comforting to know that this effort will continue long into the future – through the next cohort of nurses who enroll in NHS 3. If you are a student or graduate nurse, age 19 or older, but born after January 1, 1965, female or male, (Males have been included since 2015.) working or not, definitely click below to learn more. Enrollment for NHS 3 will remain open until 100,000 nurses have signed on. Numbers currently stand around 38,000.
http://www.nhs3.org/index.php/info/who-can-join?layout=edit
Healthy nurses will continue to contribute to our knowledge of what good health is all about!