Q & A with Author: Dental Care Utilization Among Children Aged 1–17 Years: United States, 2019 and 2020

December 2, 2021

Questions for Dzifa Adjaye-Gbewonyo, Health Statistician and Lead Author of “Dental Care Utilization Among Children Aged 1–17 Years: United States, 2019 and 2020.”

Q: Why did you decide to look at children’s dental examinations and cleanings during the pandemic?

DAG: We know that the COVID-19 pandemic required dental providers to make changes to their services, and this affected access to dental care. There have also not been many recent estimates from National Health Interview Survey (NHIS) data on preventive dental care in children, especially covering such a broad age range. So, looking at child dental care and how it changed between 2019 and 2020 was a priority research topic for the Division of Health Interview Statistics, which is responsible for the NHIS.

Q: How did the data vary by age groups, income level and region?

DAG: By age group, children aged 1-4 years had the lowest rate of dental examinations and cleanings in the past 12 months in both 2019 and 2020. They also experienced the largest decrease between the two years, from almost 59% to 51%. This contrasts with older children where the percentage ranged between 88% and 92% across age groups for the two years. By income level, fewer children living in families with lower incomes had a dental examination or cleaning in 2020 compared to 2019, while there was no significant difference between 2019 and 2020 for children with family incomes of at least 400% of the federal poverty level. Regional estimates showed that annual preventive dental visits were highest in the West and Northeast in 2019 and remained high in the West in 2020 but decreased significantly in the Northeast and in the South.

Q: What is the main takeaway message here?

DAG: I think the big takeaway is that overall, fewer children in the U.S. had an annual dental examination or cleaning in 2020 than in 2019, but the change was not the same in all segments of the child population. Some subpopulations were affected more than others, especially young children, children from lower income families, and children living in the Northeast and South. It is also important to note that we can’t fully attribute the changes to the COVID-19 pandemic because the data refer to preventive dental care in the past 12 months. So, some of this time frame took place before the pandemic.

Q: Do you plan to have adult data available for the same years?

DAG: Yes, adult data on dental care were collected and are available for 2019 and 2020. Some estimates of these data are already accessible on the NHIS website, including a data brief on urban-rural differences in dental care in 2019 and interactive quarterly and biannual estimates released through the NHIS Early Release Program. Additional analyses are also planned.

Q: Do you think the downward trend will continue into 2021?

DAG: It’s difficult to say what the trend will be in 2021 since a number of conditions have changed. Though the dental care questions rotated off the NHIS in 2021, they will return in 2022 so it will be possible to look at these data again in future years.


Concussions and Brain Injuries in Children: United States, 2020

December 1, 2021

A new NCHS report presents national estimates of lifetime symptomatology and health care professional diagnoses of concussions or brain injuries as reported by a knowledgeable adult, usually a parent, in children aged 0–17 years using data from the 2020 National Health Interview Survey.

Key Findings:

  • In 2020, 6.8% of children aged 17 years and under had ever had symptoms of a concussion or brain injury.
  • Non-Hispanic White children were more likely than children of other race and Hispanic-origin groups to have ever had symptoms of a concussion or brain injury.
  • The percentage of children aged 17 years and under who had ever had a diagnosis of a concussion or brain injury by a health care provider was 3.9%.
  • Compared with their peers, boys (4.7%) and non-Hispanic White children (5.2%) were more likely to have ever had a diagnosis of a concussion or brain injury.

QuickStats: Age-Adjusted Death Rates from Heart Disease Among Adults Aged 45–64 Years, by Urbanization Level and Sex — National Vital Statistics System, United States, 2019

November 19, 2021

In 2019, the age-adjusted death rate from heart disease among adults aged 45–64 years was 121.1 per 100,000 and was higher in rural counties (160.0) than urban counties (114.5).

Among men, the age-adjusted death rate from heart disease was 221.4 in rural counties and 165.1 in urban counties.

Among women, the age-adjusted death rate from heart disease was 99.5 in rural counties and 66.8 in urban counties. In each urbanization level, the rate was higher for men than for women.

Sources: National Vital Statistics System, Mortality Data, 2019. https://www.cdc.gov/nchs/nvss/deaths.htm; CDC Wonder online database. https://wonder.cdc.gov/ucd-icd10.html

https://www.cdc.gov/mmwr/volumes/70/wr/mm7046a8.htm


Drug Overdose Deaths in the U.S. Top 100,000 Annually

November 17, 2021

Provisional data from NCHS indicate that there were an estimated 100,306 drug overdose deaths in the United States during 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.

Read more here:

https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm

The interactive web dashboard is available at: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm


NCHS Releases Latest NHIS Early Release Data

November 16, 2021

The Early Release (ER) Program of the National Health Interview Survey (NHIS) provides estimates, analytic reports, and preliminary microdata files on an expedited schedule. NHIS data users can have access to these very timely estimates, reports, and microdata files without having to wait for the release of the final annual NHIS microdata files by selected demographic characteristics.

One of the ER reports presents estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the January through June 2021 National Health Interview Survey.

The ER program released preliminary estimates of the percentages of adults and children living in homes with only wireless telephones (also known as cellular telephones, cell phones, or mobile phones). These estimates are the most up-to-date estimates available from the federal government concerning the size and characteristics of this population.

ER also released quarterly and biannual health estimates on a variety of conditions.  The data is available on interactive web dashboards at the following links below:

Interactive Quarterly Estimates from the National Health Interview Survey, January 2019 – June 2021

https://wwwn.cdc.gov/NHISDataQueryTool/ER_Quarterly/index_quarterly.html

Interactive Biannual Estimates from the National Health Interview Survey, January 2019 – June 2021

https://wwwn.cdc.gov/NHISDataQueryTool/ER_Biannual/index_biannual.html


QuickStats: Percentage of Adults Aged 18 Years or Older Who Received an Influenza Vaccination in the Past 12 Months, by Sex and Age Group — National Health Interview Survey, United States, 2020

November 12, 2021

During 2020, 43.7% of men and 51.9% of women aged 18 years or older received an influenza vaccination in the past 12 months, and the prevalence increased with age for both sexes.

Among men, 32.7% aged 18–44 years, 43.7% aged 45–64 years, and 69.0% aged 65 years or older received an influenza vaccination.

Among women, 42.0% aged 18–44 years, 51.1% aged 45–64 years, and 72.2% aged 65 years or older received an influenza vaccination.

For each age group, women were more likely to have received an influenza vaccination compared with men.

Source: National Center for Health Statistics, National Health Interview Survey, 2020. https://www.cdc.gov/nchs/nhis/index.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7045a5.htm


Sepsis-related Mortality Among Adults Aged 65 and Over: United States, 2019

November 10, 2021

NCHS releases new report that describes sepsis-related mortality among adults aged 65 and over by age, sex, race and Hispanic origin, and urbanicity.

Key Findings:

  • Sepsis-related death rates for adults aged 65 and over varied from 2000 through 2019 but generally declined over this period.
  • Among adults aged 65 and over, sepsis-related death rates in 2019 increased with age; rates were about five times higher among adults aged 85 and over (750.0 per 100,000) compared with adults aged 65–74 (150.7).
  • In 2019, sepsis-related death rates for adults aged 65 and over were highest among non-Hispanic black adults (377.4 per 100,000) compared with non-Hispanic white (275.7), non-Hispanic Asian (180.0), and Hispanic (246.4) adults.
  • Among adults aged 65 and over, sepsis-related death rates in 2019 were higher in rural areas compared with urban areas.

Q & A with Author: Mortality Profile of the Non-Hispanic American Indian or Alaska Native Population, 2019

November 9, 2021

Questions for Elizabeth Arias, Health Statistician and Lead Author of “Mortality Profile of the Non-Hispanic American Indian or Alaska Native Population, 2019.”

Q: Is the first report on non-Hispanic American Indian or Alaska Native (AIAN) mortality? 

EA: Yes. This is the first report that NCHS publishes exclusively on non-Hispanic AIAN mortality.  Limited mortality statistics for this population has been included in our standard mortality reports.


Q: Why is there an issue of misclassification of race and ethnicity on U.S. death certificates for the AIAN population?

EA: We do not know exactly why individuals who self-identify as AIAN while alive have a higher rate of being classified as a different race on their death certificates than other racial and ethnic populations.  What we know is that funeral directors who are responsible for filling out the demographic portion of the death certificate may rely on visual observation rather than ask family informants the race of decedent.  An important factor in visual misclassification is that the proportion of multiple race individuals, predominantly individuals who identify as both AIAN and white, within the AIAN population is relatively large.   


Q: Are there any differences in the leading causes of death order for the AIAN population compared to U.S. overall?

EA: Most of the 15 leading causes of death experienced by the non-Hispanic AIAN population are the same as those affecting the total US population.  However, there are important differences.  For the non-Hispanic AIAN population, homicide is the 13th leading cause of death whereas homicide is not one of the 15 leading causes of death for the total population. The order of the 15 leading causes of death differs for the non-Hispanic AIAN population.  Of note, Chronic liver disease and cirrhosis is the 4th leading cause for this population but the 11th cause for the US overall, Suicide is the 8th vs 10th cause, and Alzheimer is the 11th vs 6th cause.


Q: Is there any trend data on life expectancy for the AIAN population prior to 2019?

EA: We publish death counts, and age-specific and age-adjusted death rates for the AIAN population annually in our final mortality reports.  However, these estimates are not adjusted for misclassification.  The most reliable mortality estimates published prior to this report were based on a linkage of Indian Health Service (HIS) patient registration data and vital statistics mortality data covering years 1990-2009.  The data covered 65% of the non-Hispanic AIAN population, those living in Contract Health Service Delivery Areas of the IHS.  A special issue of the American Journal of Publish Health was published (see American Journal of Public Health – Volume 104, Issue S3 (aphapublications.org).


Q: What is the main takeaway message from this report?

EA: Racial and ethnic health and mortality disparities in the US are profound.  The non-Hispanic AIAN mortality profile resembles that of some of the populations in the poorest, under developed countries in the world.


QuickStats: Infant Mortality Rates for Metropolitan and Nonmetropolitan Counties by Single Race and Hispanic Origin — National Vital Statistics System, United States, 2019

November 5, 2021

In metropolitan counties, infant mortality rates were highest for infants of non-Hispanic Black mothers (10.60 infant deaths per 1,000 live births), followed by infants of non-Hispanic American Indian or Alaska Native (5.95), Hispanic (4.96), non-Hispanic White (4.22), and non-Hispanic Asian (3.34) mothers.

In nonmetropolitan counties, the mortality rate was also highest for infants of non-Hispanic Black mothers (10.85), followed by infants of non-Hispanic American Indian or Alaska Native (9.78), Hispanic (5.97), non-Hispanic White (5.63), and non-Hispanic Asian (4.85) mothers.

The infant mortality rate was significantly lower for infants of non-Hispanic White, non-Hispanic American Indian or Alaska Native, and Hispanic mothers in metropolitan counties compared with nonmetropolitan counties; differences in rates between metropolitan and nonmetropolitan counties for infants of non-Hispanic Black and non-Hispanic Asian mothers were not statistically significant.

Source: National Vital Statistics System. Linked Birth and Infant Death Data. https://www.cdc.gov/nchs/nvss/linked-birth.htm


Suicide in America Declined During the Pandemic

November 3, 2021

Suicide in the United States has been on the rise for several years, becoming one of the top public health crises in the country and one that impacts Americans of all ages.  From 1999 to 2018, the number and rate of suicide increased 35%.  Suicide has frequently been among the ten leading causes of death in the country, ranking 10th as recently as 2019. 

Some of the trends in suicide may seem surprising.  For example, there has long been a belief that suicides peak during the holiday season.  But the data show that is not the case.  Over nearly two decades, December regularly has been the month with the second fewest number of suicides.  February, a shorter month, is the only month with fewer suicides.  Generally, it is the summer months in which the number of suicides peak each year.

When the pandemic struck in 2020, there was a record increase in the homicide rate and a continued spike in the number of drug overdose deaths in the country (as well as nearly 400,000 COVID-related deaths in the United States).  Many assumed suicide would also increase, particularly after the number of suicides had risen every year between 2004 and 2019.

But after a 2% decline in suicide from 2018 to 2019, there was another decline in the pandemic year of 2020.  Provisional data show the number of suicides declined 3% from 47,511 suicides in 2019 to 45,855 in 2020.  The suicide rate in the United States also declined 3% from 13.9 suicides per 100,000 in 2019 to 13.5 per 100,000 in 2020.  With COVID-19 now entrenched as the third leading cause of death in the country, suicide fell out of the top ten in 2020, dropping to 11th among leading killers. 

While the 2020 decline was surprising to some in public health, it is worth noting that the 2020 number and rate of suicide are still higher than any year in history, except for the period 2017-2019. 

These data are featured in a new report, “Provisional Numbers and Rates of Suicide by Month and Demographic Characteristics: United States: 2020,” released on November 3.  The new report documents that:

  • The monthly number of suicides was lower in 2020 than in 2019 in March through October and also in December.
  • The number of suicides were higher in January and February of 2020 than the previous year.  This period was just before the pandemic led to widespread lockdowns and business closures in March of 2020.
  • The largest percentage difference between monthly numbers for 2019 and 2020 occurred in April.  The provisional number in April 2020 (3,468) was 14% lower than in April 2019 (4,029).
  • Yet, April 2020 was also the month of the first spike in COVID-19 deaths in the country.

 Other findings in the new report:

  • The suicide rate was 2% lower in 2020 than in 2019 for males and 8% lower for females.
  • Suicide rates declined for females in all race and Hispanic-origin groups between 2019 and 2020, although only the 10% decline for non-Hispanic white females was significant.
  • Rates declined for non-Hispanic white and non-Hispanic Asian males but increased for non-Hispanic black, non-Hispanic American Indian or Alaska Native, and Hispanic males.
  • The 3% decline for non-Hispanic white males and the 5% increase for Hispanic males was significant. 

Final suicide data for 2020 are expected to be available in December of this year, along with other final 2020 data for causes of death in the country.