Trends in Cancer and Heart Disease Death Rates Among Adults Aged 45–64: United States, 1999–2017

May 22, 2019

Questions for Sally Curtin, M.A., Statistician, and Lead Author of “Trends in Cancer and Heart Disease Death Rates Among Adults Aged 45–64: United States, 1999–2017.”

Q:  Why are death rates from cancer dropping steadily over time and why are death rates from heart disease starting to rise?

SC: The death rates are a reflection of a few things—the prevalence of a disease, how often is occurs in the population, as well as its treatment and survival.  As this is purely a statistical analysis, others can speak to the trends in these factors.


Q:  You write that cancer treatments might contribute to subsequent heart disease for patients and might help explain the increase in heart disease mortality.  Which cancer treatments are contributing to this subsequent heart disease among cancer patients?

SC: The cardiotoxicity of cancer treatments is just one way that these two seemingly disparate diseases are related.  It is well known in the medical community that radiation and many chemotherapies can increase the risk of subsequent heart disease. In our analysis, we didn’t examine which treatments might be contributing to heart disease risk.


Q:  Which groups are seeing the biggest decline in cancer death rates?

SC: Non-hispanic black men, who have the highest cancer death rates, also had the largest percentage decline over the period at 34%.  In general, the percentage declines were greater for men than for women.


Q:  Which groups are seeing the biggest increase in heart disease death rates?

SC: Non-hispanic white women had a 12% increase since 2009 in heart disease death rates, the greatest of all groups.  In total, middle-aged women had a 7% recent increase compared with 3% for middle-aged men.  Another interesting finding is that Hispanic women, who had the lowest heart disease death rates of all groups, had a 37% decline over the period, the only group to experience a decline over the entire period.


Q:  Does this analysis suggest that cancer will not overtake heart disease as the leading cause of death in the U.S., which many have been predicting?

SC:  The focus of this report was on the middle-age population, and Cancer is the leading cause of death in the 45-64 year old population as shown in this report, whereas heart disease remains the leading cause in the total population.  While we do not make predictions about what data trends will look like in the future, it is safe to say that if the recent upturn in heart disease continues, it is unlikely that this switch will occur anytime soon.

 

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Strategies Used by Adults Aged 65 and Over to Reduce Their Prescription Drug Costs, 2016-2017

May 22, 2019

Questions for Robin Cohen, Ph.D. and Lead Author of “Strategies Used by Adults Aged 65 and Over to Reduce Their Prescription Drug Costs, 2016-2017

Q: Why did you decide to do a report on strategies used to reduce prescription drug costs in the United States?

RC: Although most adults aged 65 and over have prescription drug coverage through either Medicare Part D or some other source such as private health insurance Medicaid, or VA coverage, previous data indicate that some older adults may still use strategies to reduce prescription drug costs including not taking medication as prescribed or asking their doctor for a lower cost medication.


Q: Do you have data that directly corresponds with this report that goes back further than 2016-2017?

RC: We previously examined this topic using the 2013 National Health Interview Survey. However, this previous report was not solely focused on adults aged 65 and over.


Q: How did the data vary by age, sex and insurance coverage?

RC: In 2016–2017, among U.S. adults aged 65 and over who were prescribed medication in the past 12 months, the percentage who did not take their medication as prescribed or asked their doctor for a lower-cost medication to reduce their prescription drug costs varied by sex, age, insurance status, and poverty status. Among adults aged 65 and over, women, those aged 65–74, those with Medicare only, and those who were near poor were the most likely to not take their medication as prescribed. Adults aged 75 and over, those with Medicare and Medicaid coverage, and those who were not poor were the least likely to ask their doctor for a lower-cost medication.


Q: Was there a specific finding in your report that you did not expect?

RC: No, the findings in this report were similar to those previously published with earlier data. However in this report we were able to expand on previous research by focus on adults aged 65 and over and examine differences by sex, age group, health insurance status, and poverty status.


Q: What is the take home message for this report?

RC: Among adults aged 65 and over who were prescribed medication in the past 12 months, 4.8% did not take their medication as prescribed to reduce their prescription drug costs, and 17.7% asked their doctor for a lower-cost medication. Among adults aged 65 and over, women, those aged 65–74, those with Medicare only, and those who were near poor were the most likely to not take their medication as prescribed. Adults aged 75 and over, those with Medicare and Medicaid coverage, and those who were not poor were the least likely to ask their doctor for a lower-cost medication.

 


Melanoma Deaths Down Four Years in a Row in 2017

May 15, 2019

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Source:  National Vital Statistics System, CDC WONDER, 1999-2017 (http://wonder.cdc.gov).  This chart represents the number of deaths from ICD-10 code C 43 “Malignant melanoma of the skin”


Updated Provisional Drug Overdose Death Data: 12-Month Ending from October 2017- October 2018

May 15, 2019

Link: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm


Births: Provisional Data for 2018

May 15, 2019

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2018.”

Q: How does the provisional 2018 birth data compare to previous years?

BH: The  number of births, the general fertility rate, the total fertility rate, birth rates for women aged 15-34, the cesarean delivery rate and the low-risk cesarean delivery rate declined from 2017 to 2018, whereas the birth rates for women aged 35-44 and the preterm birth rate rose.


Q: When do you expect the final 2018 birth report to come out?

BH: The 2018 final birth report is scheduled for release in the fall of 2019.


Q: How did the data vary by age and race?

BH:  Birth measures shown in the report varied widely by age and race and Hispanic origin groups. Birth rates ranged from 0.2 births per 1,000 females aged 10-14 to 99.6 births per 1,000 women aged 30-34. By race and Hispanic origin, the cesarean delivery rate ranged from 28.7% of births for non-Hispanic American Indian or Alaska Native women to 36.1% for non-Hispanic black women and the preterm birth rate ranged from 8.56% for non-Hispanic Asian women to 14.12% for non-Hispanic black women.


Q: Was there a specific finding in the provisional data that surprised you?

BH: The report includes a number of interesting findings. The record lows reached for the general fertility rate, the total fertility rate and birth rates for females aged 15-19, 15-17, 18-19, and 20-24 are noteworthy. In addition, the magnitude of the continued decline in the birth rate for teens aged 15-19, down 7% from 2017 to 2018, is also historic.


Q: What is the take home message for this report?

BH:  The number of births for the United States was down 2% from 2017 to 2018, as were the general fertility rate and the total fertility rate, with both at record lows in 2018. Birth rates declined for nearly all age groups of women under 35, but rose for women in their late 30s and early 40s. The birth rate for teenagers aged 15–19 was down 7% from 2017 to 2018. The cesarean delivery rate and low-risk cesarean delivery rate were down in 2018. The preterm birth rate rose for the fourth year in a row in 2018.


Q: Do you anticipate this drop will continue?

BH: The factors associated with family formation and childbearing are numerous and complex. The data on which the report are based come from all birth certificates registered in the U.S. While the scope of these data is wide, with detailed demographic and health   information on rare events, small areas, or small population groups, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, these data do not answer the question of why the number of births dropped in 2018 or if the decline will continue.


QuickStats: Age-Adjusted Percentages of Persons of All Ages Who Delayed Seeking Medical Care in the Past 12 Months Because of Worry About Cost,† by U.S. Census Region of Residence — National Health Interview Survey, 2012 and 2017

May 10, 2019

The percentage of persons of all ages who delayed seeking medical care in the past 12 months because of worry about the cost decreased from 8.2% in 2012 to 6.3% in 2017, and this pattern was consistent in each U.S. Census region of residence.

Delays in seeking medical care because of worry about the cost declined from 5.8% to 4.4% in the Northeast, from 8.4% to 6.6% in the Midwest, from 8.7% to 7.3% in the South, and from 9.1% to 5.9% in the West.

In both 2012 and 2017, persons of all ages living in the Northeast were the least likely to delay medical care because of worry about the cost.

SOURCE: Summary Health Statistics for the U.S. Population, National Health Interview Survey, 2012. https://www.cdc.gov/nchs/data/series/ sr_10/sr10_259.pdfpdf icon.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6818a5.htm


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2018

May 9, 2019

Questions for Emily P. Terlizzi, M.P.H., Associate Service Fellow and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2018

Q; How did the uninsured vary by age groups and compare to last year in this report?

ET: In 2018, 9.4% of persons of all ages, 11.1% of persons under age 65, 5.2% of children, and 13.3% of adults aged 18-64 lacked health insurance at the time of interview. In 2017, 9.1% of persons of all ages, 10.7% of persons under age 65, 5.0% of children, and 12.8% of adults aged 18-64 lacked health insurance at the time of interview. However, between 2017 and 2018, none of these differences by age group were significantly different.


Q: How did the uninsured vary by regions in the United States?

ET: In 2018, 7.7% of adults aged 18-64 living in the Northeast, 11.1% of those living in the Midwest, 18.4% of those living in the South, and 11.6% of those living in the West lacked health insurance coverage at the time of interview.


Q: Has there been an increase in the percentage of persons with private coverage enrolled in high deductible health plans?

ET: In 2018, almost 45.8% of persons under age 65 with private coverage were enrolled in a high-deductible health plan (HDHP). The percentage of persons enrolled in a HDHP has increased 20.5 percentage point since 2010.


Q: What is new in this report?

ET: This report provides health insurance estimates for the United States and 17 selected states using a full year of 2018 National Health Interview Survey data. Among adults aged 18–64 the percentage who were uninsured ranged from 4.9% in Massachusetts to 25.0% in Texas.


Q: What is the take home message for this report?

ET: The take-home message from this report is found in the number of Americans who no longer lack health insurance. In 2018, 30.4 million (9.4%) persons of all ages were uninsured at the time of interview. This estimate is not significantly different from the 29.3 million (9.1%) in 2017, but there are 18.2 million fewer uninsured persons than in 2010.