Boston Area Community Health (BACH) Survey

The Boston metropolitan area is serving as a laboratory for this NIDDK-sponsored epidemiologic study, which is examining a range of urological problems that profoundly affect the daily lives of Americans. The study is examining the prevalence of symptoms for health problems such as interstitial cystitis, urinary incontinence, benign prostatic hyperplasia, prostatitis, hypogonadism, and sexual function. By the time the study ends, approximately 6,000 men and women, ages 30 to 79, from four Boston area neighborhoods that have density levels proportionate with minority populations will have been interviewed in their homes. One third of the randomly sampled population will be African American; one third, Hispanic; and one third, Caucasian.

To achieve a randomly sampled population, the four neighborhoods were divided into 12 strata and from them investigators selected census blocks. Households were then randomly selected from the census blocks and sampled to identify eligible study participants. The BACH study has a unique design that involves sampling in batches of 1,000. Each batch is a random sample of the overall study population.

According to Dr. John McKinley, principal investigator of BACH, designing an epidemiological study of IC is a challenge for an epidemiologist because of the variability of symptoms. Some patients do not recognize IC as a problem and some providers do not diagnose it; therefore, it is necessary to perform symptom-based research. Also, some patients do not receive a diagnosis or treatment because they do not have access to health care.

Investigators conduct a two-hour, in-home, bilingual field interview of all eligible participants, looking at symptoms and asking questions about lifestyle, physical activity, alcohol use, nutrition, demographics, and morbidity. They also conduct a detailed inventory of medications, both prescribed and over-the-counter, and take two non-fasting blood samples for hormone, cholesterol, and lipid levels that will be stored for future studies.

Of interest to the survey are health disparities and inequalities. BACH is especially concerned with lack of adequate health insurance, lack of access to adequate medical care, and how these problems influence patterns of disease. The study will also focus on social determinants of disease that are over and above the contribution of individual characteristics and risk factors.

A neighborhood Community Advisory Board is guiding the survey. The board comprises members from service, business, and health organizations in the community as well as state and city officials.