Problems Paying Medical Bills Among Persons Under Age 65: Early Release of Estimates From the National Health Interview Survey, 2011-June 2016

November 30, 2016

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Problems Paying Medical Bills Among Persons Under Age 65: Early Release of Estimates From the National Health Interview Survey, 2011-June 2016

Q: What do you think is the most significant finding in your new study?

RC: I think the key finding in this report is that between 2015 and the first 6 months of 2016, there was little change in the percentage of persons under age 65 who were in families having problems paying medical bills.


Q: How have trends for families having problems paying medical bills in the United States changed in 2016 since you began examining this issue?

RC: We’ve noticed a continuing drop in those experiencing difficulties making their medical bill payments. The number of persons under age 65 who were in families having problems paying medical bills has decreased from 56.5 million in 2011 to 43.8 million in the first 6 months of 2016.


Q: Is paying for health insurance premiums considered a medical bill in your study?

RC: Premiums are not considered a medical bill in our study. Medical bills include bills for doctors, dentists, hospitals, therapists, medication, equipment, nursing home, or home care.


Q: What are the trends among race and ethnicity groups who are having problems paying medical bills this year and compared over time?

RC: We’ve observed a number of trends among different groups over time. All race and ethnicity groups studied in the report saw decreases in the percentage of persons under age 65 who were in families having problems paying medical bills between 2011 and the first 6 months of 2016. Within each year from 2011 through 2016, non-Hispanic Asian persons were the least likely to be in families having problems paying medical bills.


Q: What is the take-home message of your report?

RC: I think the take-home message from this research is the story the data offers about American families–that among persons under age 65, one in six persons is in a family having problems paying medical bills.


QuickStats: Percentage of Adults Aged 20 Years or Older Who Ever Told A Doctor That They Had Trouble Sleeping, by Age Group and Sex

November 29, 2016

In 2013–2014, 28% of U.S. adults reported that they had told a doctor or other health professional that they had trouble sleeping.

A smaller percentage of adults aged 20–39 years (19.2%) reported having trouble sleeping compared with persons aged 40–59 years (32.8%) and 60 years or older (33.2%).

This pattern by age group was observed for both men and women, although larger percentages of women aged 40–59 years and ≥60 years reported trouble sleeping compared with men in those age groups.


Provisional Estimates of Birth Data for 2014 through the Second Quarter of 2016

November 22, 2016

NCHS has released provisional estimates of selected reproductive indicators from birth data for 2014 through the second quarter of 2016. Estimates for 2014 and 2015 are based on final data.

The estimates for the first and second quarter of 2016 are based on all birth records received and processed by NCHS as of August 28, 2016.

Estimates are presented for: general fertility rates, age-specific birth rates, total and low risk cesarean delivery rates, preterm birth rates and other gestational age categories. These indicators were selected based on their importance for public health surveillance as well as the feasibility of producing reliable estimates using available provisional data. Future quarterly releases will include additional birth indicators from natality data.

Quarterly estimates are compared with estimates for the same quarter of the preceding year; for example, the second quarter of 2016 is compared with the second quarter of 2015. For comparability with rates for 12-month periods, the quarterly (3-month) rates have been annualized to present births per year per 1,000 population that would be expected if the quarter-specific rate prevailed for 12 months.

In addition, the rates and percentages for a 12-month period ending with each quarter (i.e., 12-month moving average) are presented to account for seasonality. Estimates for the 12-month period ending with the fourth quarter in each year can be interpreted as an annual provisional estimate for that year.

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QuickStats: Average Infant Mortality Rate by Month — National Vital Statistics System, United States, 2010–2014

November 21, 2016

During 2010–2014, the infant mortality rate averaged approximately 6.00 infant deaths per 1,000 live births each month.

The infant mortality rate peaked in February and April at approximately 6.30 and was lowest from July to September with approximately 5.71 infant deaths per 1,000 live births.

Source: https://www.cdc.gov/mmwr/volumes/65/wr/mm6545a11.htm


Sports and Recreation Related Injury Episodes in the United States, 2011-2014

November 18, 2016
Yahtyng Sheu, Senior Service Fellow

Yahtyng Sheu, Senior Service Fellow

Questions for Yahtyng Sheu, Senior Service Fellow and Lead Author on “Sports and Recreation Related Injury Episodes in the United States, 2011-2014

Q: How many sports and recreation related injuries are being reported annually?

YS: According to our analysis, approximately 8.6 million of sports- and recreation- related injury episodes were reported annually among persons aged 5 and over using data from the 2011-2014 National Health Interview Survey. These injury episodes were medically-attended, for which a health care professional was contacted, either in person or by telephone, for advice or treatment. Therefore, these injury episodes were not limited to those resulted in emergency department visit or hospitalization.


Q: Did the sports and recreation related injuries differ by sex and age group? If so how?

YS: Yes. The distribution of sports- and recreation-related injuries differed by both sex and age. Approximately 60% of all the sports- and recreation-related injuries were sustained by men. Children and young adults between age 5 and 24 years old also accounted for 65% of the total sport- and recreation-related injuries.


Q: What types of sports and recreation activities are causing these injuries?

YS: Our data shows that general exercise, which includes aerobics, exercising, weight training, running, jogging, and school related activity, was the most frequently mentioned activity associated with sports-and recreation-related injuries. However, it does not mean that general exercise is more likely to “cause” injuries. We are unable to study what activities are more likely to cause injuries because the National Health Interview Survey do not collect data on activity participation. This prevents us from evaluating the risk of injury for individual activity.


Q: What parts of the body were more frequently injured while engaging in sports and recreation?

YS: Lower (42%) and upper (30%) extremities were the most frequently mentioned parts of body injured while engaging in the sports and recreation activity.


Q: Why did you decide to look at sports and recreation related injuries?

YS: Many epidemiological studies of sports- and recreation-related injuries have focused on specific populations, sport activities, or outcomes. Limited number of studies have provided national estimates on overall sports- and recreation-related injuries among all population. The latest national estimates on these type of injuries (that are not limited to emergency department visits data) were derived from 1997-1999 data. As more people engage in sports and recreation activity, we feel there is a need to address the patterns of sports- and recreation- related injuries using more recent data.


Age Differences in Visits to Office-based Physicians by Adults with Hypertension: United States, 2013

November 17, 2016
Jill J. Ashman, Ph.D., Health Statistician

Jill J. Ashman, Ph.D., Health Statistician

Questions for Jill J. Ashman, Ph.D., Health Statistician and Lead Author on “Age Differences in Visits to Office-based Physicians by Adults With Hypertension: United States, 2013

Q: Why did you choose age differences as the demographic focus of your study?

JA: I wanted to examine this demographic because of the dramatic differences by age I was seeing in preliminary analyses. For instance, the increase by age in the percentage of adult visits to office-based physicians made by adults with hypertension is large–going from 9% of adults aged 18-44 to 58% of adults aged 75 and over.


Q: What do you think is the most significant finding in your new study?

JA: Probably, the most significant finding is that 34% of all adult visits to office-based physicians were made by adults with hypertension, representing an estimated 259 million office visits in 2013.


Q: How likely was it that medication(s) for high blood pressure were included as part of the treatment that Americans with hypertension were getting at their doctors’ offices?

JA: VERY LIKELY! Hypertensive medications were provided, prescribed, or continued at 62% of office-based physician visits made by adults with hypertension, and the percentage with hypertensive medications increased with age. Half of visits by patients aged 18-44 with hypertension included hypertensive medications whereas this percentage increased to 65% for visits by patients aged 75 and over with hypertension.


Q: Among American adults with high blood pressure, is hypertension the only condition they have when they visit their doctors’ offices?

JA: Hypertension is NOT their only health concern. Eighty-two percent of visits in 2013 that were made by adults with hypertension were made by patients who had been diagnosed with other chronic conditions. A quarter of the visits by adults with hypertension were made by patients who had been diagnosed with 4 or more chronic conditions.


Q: What is the take home message of your report?

JA: I think it’s important to note that regardless of age, adults with hypertension use extensive health resources as evidenced by frequent visits to the doctor (47% of all such visits including four or more visits to the same doctor in the past year) and that there is extensive use of hypertensive medications, with 62% of all such visits including one or more hypertensive medications.


Teen Birth Rates for Urban and Rural Areas in the United States, 2007–2015

November 16, 2016

Questions for Brady Hamilton, Statistician and Lead Author of “Teen Birth Rates for Urban and Rural Areas in the United States, 2007–2015

Q: Are teen birth rates in the U.S. higher in urban areas or rural areas?

BH: The birth rate for teenagers is higher in rural areas than in urban areas. In 2015, the rate was 30.9 births per 1,000 females aged 15-19 for rural areas compared with 20.9 for urban areas. This difference persisted over the duration of the study, from 2007 through 2015, and was seen in the teen birth rates for non-Hispanic white, non-Hispanic black, and Hispanic females.


Q: What explains the differences or similarities in the two areas?

BH: The data on which the report is based comes from the birth certificates filed in all states and DC. While the data from the birth certificate provide detailed information on a number of topics, this report did not examine reasons for urban/rural differences, as information on many contributing factors is not available from the birth certificate.

However, the report shows that while the birth rate for teenagers is higher in rural areas than in urban areas, birth rates for all areas declined from 2007 through 2015, down 50% in large urban, 44% in medium and small urban, and 37% in rural areas.


Q: What were some of the regional differences you observed in teen birth rates in urban or rural areas?

BH: The urban teen birth rate declined for all states and DC between 2007 and 2015, with declines ranging from 24% for teens in North Dakota to 57% for teens in Arizona, whereas the rural teen birth rate declined for in nearly all states, with declines ranging from 18% for teens in Alaska to 73% for teens in Connecticut.

Among the urban areas, states with the largest declines (50% or more in the teen birth rate) include: Arizona, California, Colorado, Connecticut, Florida, Georgia, Maryland, Massachusetts, Minnesota, Mississippi, New Jersey, New Mexico, North Carolina, Rhode Island, Utah, Vermont, and Virginia.

Among the rural areas, states with the largest declines (50% or more in the teen birth rate) include: Colorado and Connecticut.


Q: Are there any data which suggests sexual activity among teens is higher in urban vs. rural areas – or vice versa?

BH: As noted, information is not available from the birth certificate on the attitudes and behavior of the parents associated with fertility and family formation.


Q: What are the differences in teen birth rates among race/ethnic groups and are there different patterns among these groups depending on whether they live in urban or rural areas?

BH: Teen birth rates for non-Hispanic white, non-Hispanic black, and Hispanic females were highest in rural counties and lowest in large urban areas in 2015.

For each area, the teen birth rate was consistently highest for Hispanic females and consistently lowest for non-Hispanic white females.

The difference in the teen birth rate between rural and large urban areas was lowest for non-Hispanic black females and greatest for non-Hispanic white females.

Q: Which U.S. counties have the highest teen birth rate and which counties have the lowest?

A: Teen birth rates are not available for individual counties in the report. Counties are grouped into areas according to their urban or rural designation and the teen birth rate was reported for an area based on the aggregated data of the counties for the area.