title: Evaluation of failure to follow vaccination recommendations as a marker for failure to follow other health recommendations.
abstract: OBJECTIVE
  To determine whether families who fail to vaccinate their children also fail to follow other health recommendations.
  
  
  METHODS
  US civilian noninstitutionalized population.
  
  
  METHODS
  National survey with a stratified cluster design.
  
  
  METHODS
  Adult respondents for children 19 to 35 months of age surveyed in the 1991 National Health Interview Survey with documented vaccination history.
  
  
  METHODS
  Comparison of responses to 23 questions related to health behaviors between respondents of up-to-date (UTD), i.e. having received 4 doses of diphtheria and tetanus toxoids and pertussis vaccine, 3 doses of polio vaccine and one measles vaccine, and non-UTD children.
  
  
  RESULTS
  Of the 781 studied children, non-UTD (n = 357) and UTD (n = 424) children, or their respondents, did not differ in 18 of the 23 studied health behaviors. However, although non-UTD and UTD children were equally likely to have car seats, non-UTD children were less likely to use them always (84.3% vs. 92.9%, P = 0.002). National Health Interview Survey respondents of non-UTD children were more likely than their counterparts never to read food labels for ingredients (28.9% vs. 20.5%, P = 0.04) or for fat/cholesterol content (33.6% vs. 22.3%, P = 0.02) and never to buy low salt foods (37.5% vs. 21.5%, P = 0.001). Multivariate analyses showed that parental education level, not a child's vaccination status, was associated with compliance with the studied health behaviors.
  
  
  CONCLUSIONS
  Failure to vaccinate children on time is not consistently related to the likelihood of family member's following of other health recommendations. However, these data suggest that although mediated via parental educational levels, a child's immunization status helps to define families at risk for poor nutrition-related behaviors and those who are in need of counseling on seat belt use.
authors.affiliation: National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA, USA. vxd0@cdc.gov
authors.forename: V J
authors.initials: VJ
authors.lastname: Dietz
authors.forename: M
authors.initials: M
authors.lastname: Lewin
authors.forename: E
authors.initials: E
authors.lastname: Zell
authors.forename: L
authors.initials: L
authors.lastname: Rodewald
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015438:Health Behavior; D006801:Humans; D007223:Infant; D015999:Multivariate Analysis; D014611:Vaccination