May 22, 2015

The state of North Carolina scores higher than the nation overall in births to unmarried mothers, preterm births, teen births and low birthweight. The state also has a higher homicide rate and higher mortality rate from drug overdose deaths than the national rate.

However, the Tar Heel state has a larger proportion of its population with health insurance than the national average and a lower mortality rate in heart disease than the national rate.

Here is a list of the 15 leading causes of death in North Carolina in 2013 with ICD 10 codes:

  1. Malignant neoplasms (C00-C97)
  2. Diseases of heart (I00-I09,I11,I13,I20-I51)
  3. Chronic lower respiratory diseases (J40-J47)
  4. Cerebrovascular diseases (I60-I69)
  5. Accidents (unintentional injuries) (V01-X59,Y85-Y86)
  6. Alzheimer’s disease (G30)
  7. Diabetes mellitus (E10-E14)
  8. Influenza and pneumonia (J09-J18)
  9. Nephritis, nephrotic syndrome and nephrosis (N00-N07,N17-N19,N25-N27)
  10. Septicemia (A40-A41)
  11. Intentional self-harm (suicide) (U03,X60-X84,Y87.0)
  12. Chronic liver disease and cirrhosis (K70,K73-K74)
  13. Essential hypertension and hypertensive renal disease (I10,I12,I15)
  14. Parkinson’s disease (G20-G21)
  15. Pneumonitis due to solids and liquids (J69)

Insurance Status by State Medicaid Expansion Status: Early Release of Estimates From the National Health Interview Survey, 2013–September 2014

May 21, 2015

Under the Affordable Care Act, states have the option to expand Medicaid coverage to all eligible persons with incomes up to 138% of the federal poverty level (FPL). Previous research has shown that there have already been significant decreases in the percentages of persons who were uninsured between 2013 and the first 9 months of 2014.

Using data from 2013 and the second and third quarters (April through September) of the 2014 National Health Interview Survey (NHIS), a new NCHS report examines changes in the percentage of persons who were uninsured, by state Medicaid expansion status, age, and poverty status.

Data from the second and third quarters of the 2014 NHIS were chosen for this analysis because they capture the surge in enrollment in the Health Insurance Marketplace and state-based exchange plans that occurred in March and the beginning of April 2014. Data from the fourth quarter of the 2014 NHIS are not yet available.

Key Findings from the Report:

  • The percentage of adults aged 18–64 who were uninsured at the time of interview decreased from 20.4% in 2013 to 15.9% in April–September 2014.
  • Adults aged 18–64 with family incomes less than or equal to 138% of the FPL in Medicaid expansion states had a larger decrease in the percentage uninsured (10.2 percentage points) than those with similar income in nonexpansion states (3.3 percentage points) from 2013 to April–September 2014.
  • Between 2013 and April–September 2014, the percentage of uninsured adults aged 18–34 with incomes less than or equal to 138% FPL decreased 9.1 percentage points in Medicaid expansion states, compared with only 0.7 percentage points in nonexpansion states.
  • The greatest absolute decrease in the percentage uninsured from 2013 to April–September 2014 (12.1 percentage points) was among adults aged 45–64 with incomes less than or equal to 138% FPL in Medicaid expansion states.


Maternal Morbidity for Vaginal and Cesarean Deliveries, According to Previous Cesarean History: New Data From the Birth Certificate, 2013

May 20, 2015

A new NCHS report presents recent findings for 2013 on four maternal morbidities associated with labor and delivery—maternal transfusion, ruptured uterus, unplanned hysterectomy, and intensive care unit (ICU) admission—that are collected on birth certificates for a 41-state and District of Columbia reporting area, which represents 90% of all births in the United States.

Key Findings from the Report:

  • Rates of maternal morbidity were higher for cesarean than vaginal deliveries—rates of transfusion (525.1 per 100,000) and ICU admission (383.1) were highest for primary cesarean deliveries, while rates of ruptured uterus (88.9) and unplanned hysterectomy (143.1) were highest for repeat cesarean deliveries.
  • Higher rates of maternal morbidity for cesarean compared with vaginal deliveries were found for nearly all maternal age groups and for women of all races and ethnicities.
  • Women with no previous cesarean delivery who had vaginal deliveries had lower rates for all maternal morbidities compared with those who had cesarean deliveries.
  • Women with a previous cesarean delivery who labored and had vaginal birth generally had lower rates for most of the morbidities, but failed trials of labor were generally associated with higher morbidity than scheduled repeat cesarean deliveries, especially for ruptured uterus, which was seven times higher (495.4 per 100,000 compared with 65.6).


Association Between Diagnosed ADHD and Selected Characteristics Among Children Aged 4–17 Years: United States, 2011–2013

May 14, 2015

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder diagnosed in U.S. children. While this disorder is most often diagnosed in children when they are in elementary school, it is increasingly being identified in preschool children.

A new NCHS report describes the prevalence of diagnosed ADHD among children aged 4–17 years using parent-reported data collected in a large, nationally representative health survey. Differences in the prevalence of diagnosed ADHD are examined by selected demographic and socioeconomic variables: the child’s sex, race and Hispanic ethnicity, health insurance coverage, and poverty status for all children aged 4–17 and among age groups 4–5, 6–11, and 12–17.

Key Findings from the Report:

  • In 2011–2013, 9.5% of children aged 4–17 years were ever diagnosed with attention deficit hyperactivity disorder (ADHD). For those aged 4–5, prevalence was 2.7%, 9.5% for those aged 6–11, and 11.8% for those aged 12–17.
  • Among all age groups, prevalence of ever diagnosed ADHD was more than twice as high in boys as girls.
  • Among those aged 6–17, prevalence was highest among non-Hispanic white children and lowest among Hispanic children.
  • Among all age groups, prevalence was higher among children with public insurance compared with children with private insurance.
  • Among children aged 4–11, prevalence was higher for children with family income less than 200% of the federal poverty threshold than for children with family income at 200% or more of the poverty threshold.

Dental Caries and Tooth Loss in Adults in the United States, 2011–2012

May 14, 2015

Dental caries and tooth loss are important oral health indicators for adults and are key measures for monitoring progress toward health promotion goals set by Healthy People 2020. Although tooth decay and complete tooth loss have been declining in the United States since the 1960s, disparities have remained between some groups. As adults age, oral health-related quality of life is negatively affected by tooth loss and decay.

A new NCHS report describes U.S. adult dental caries and tooth loss by age and race and Hispanic origin for 2011–2012.

Key Findings from the Report:

  • Among adults aged 20–64, 91% had dental caries and 27% had untreated tooth decay.
  • Untreated tooth decay was higher for Hispanic (36%) and non-Hispanic black (42%) adults compared with non-Hispanic white (22%) and non-Hispanic Asian (17%) adults aged 20–64.
  • Adults aged 20–39 were twice as likely to have all their teeth (67%) compared with those aged 40–64 (34%).
  • About one in five adults aged 65 and over had untreated tooth decay.
  • Among adults aged 65 and over, complete tooth loss was lower for older Hispanic (15%) and non-Hispanic white (17%) adults compared with older non-Hispanic black adults (29%).

Hepatitis Awareness Month

May 12, 2015

Immunization appears to have had a dramatic impact on controlling some forms of Hepatitis in the United States over the past two decades.  In 1990, there were 31,441 new cases of Hepatitis A and 21,102 new cases of Hepatitis B reported in the U.S.   Two decades later, the number of new cases has dropped dramatically:  1,562 new cases of Hepatitis A were reported in 2012 along with 2,895 new cases of Hepatitis B.

In 2010, NCHS released data from the National Health and Nutrition Examination Survey, which showed that among younger Americans between ages 6 and 29, exposure to the Hepatitis A virus (HAV) had increased steadily between 1988-94 and 2003-06, while a decline occurred among adults age 40 and over during the same period.

Prevalence of Heptatitis B (HBV) infection, meanwhile, declined steadily over the same period of time for people of all age groups (It is important to note that there is a distinction between exposure to HAV or HBV in a nationally representative sample survey like NHANES and the actual number of diagnosed cases reported to CDC).

Deaths from viral hepatitis, meanwhile, have been inching up.   In 2013, 8,157 Americans died from all forms of viral hepatitis, up significantly from 4,853 deaths in 1999.

For more information on Hepatitis vaccination, visit the CDC web site at

Food Allergy Action Month

May 11, 2015

May is Food Allergy Action Month.  Food allergy is a potentially serious immune response to eating specific foods or food additives. Eight types of food account for over 90% of allergic reactions in affected individuals: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat.  Reactions to these foods by an allergic person can range from a tingling sensation around the mouth and lips and hives to death, depending on the severity of the allergy. The mechanisms by which a person develops an allergy to specific foods are largely unknown.

Food allergy is more prevalent in children than adults, and a majority of affected children will “outgrow food” allergies with age. However, food allergy can sometimes become a lifelong concern.

Among children under 17 years old, the prevalence of food allergies increased from 3.4% in 1997– 1999 to 5.1% in 2009–2011.  Hispanic children had a lower prevalence of food allergy compared with non-Hispanic white and non-Hispanic black children.

The prevalence of food allergy increased with income level. Among children with family income less than 100% of the poverty level, 4.4% had a food allergy. Food allergy prevalence among children with family income between 100% and 200% of the poverty level was 5%.

From 2004 to 2006, there were approximately 9,500 hospital discharges per year with a diagnosis related to food allergy among children under age 18 years.

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