QuickStats: Percentage of Adults Aged 20 or Older Years Who Reported Being Told by a Doctor or Health Professional to Increase Their Physical Activity by Age Group and Obesity StatusOctober 27, 2017
During 2011–2014, 33.2% of adults aged 20 years or older reported that a doctor or health professional told them to increase their physical activity.
More than half (52.2%) of adults aged 20 years or older with obesity reported that a doctor or health professional told them to increase their physical activity compared with less than a quarter (22.3%) of adults without obesity.
This pattern remained the same for all age groups examined. For both adults with and without obesity, the proportion who reported being told to increase their physical activity increased with age.
Source: National Center for Health Statistics, National Health and Nutrition Examination Survey, 2011–2014.
Questions for Margaret Carroll, M.S.P.H., Health Statistician and Lead Author on “Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2016”
Q: How has the prevalence of high total cholesterol and low levels of high-density lipoprotein (HDL) in U.S. changed since 1999-2000 to 2015-2016?
MC: The prevalence of high total cholesterol (>=240 mg/dL) of adults 20 years and older declined from 1999-2000 to 2015-2016; the prevalence of low high-density lipoprotein(HDL) cholesterol (<40 mg/dL) declined in adults 20 years and older from 2007-2008 to 2015-2016. No change was seen from 2013-2014 to 2015-2016 in either high total cholesterol or low HDL cholesterol.
Q: Why is it important to study the prevalence of high total and low HDL cholesterol?
MC: High levels of total cholesterol and low levels of HDL cholesterol are risk factors for cardiovascular disease, the leading cause of death in the United States.
Also, as part of its objectives to improve the health of the U.S. population, Healthy People 2020 has included the goal of reducing the proportion of adults with high total blood cholesterol to less than 13.5%. Both men and women aged 20 and over currently meet this goal. However, not all subgroups meet this target.
Q: Was there anything in the report that surprised you?
MC: The findings did not particularly surprise me. Based on the earliest available and comparable data from the National Health and Nutrition Examination Survey (NHANES), declining trends were observed in high total cholesterol from 1999–2000 to 2015–2016 and in low HDL cholesterol from 2007–2008 to 2015–2016. However, the observed change for high total and low HDL cholesterol from 2013–2014 to 2015–2016 was not statistically significant.
Q: How does the prevalence of high total and low HDL cholesterol breakdown by age and gender in U.S.?
MC: Men ages 40-59 years have a higher prevalence of high total cholesterol than men ages 20-39 years and 60 years and older but there is no significant difference between men 20-39 years and those 60 years and older. The prevalence of high total cholesterol is lower in women ages 20-39 years than in women 40-59 years and 60 years and older but there is no significant difference between women 40-59 years and 60 years and older.
Men ages 40-59 years have a higher prevalence of low HDL cholesterol than men 60 years and older. A declining trend in the prevalence of low HDL cholesterol was seen in women from 20-39 years and 60 years and older.
Q: What is the take-home message from this report?
MC: High total cholesterol has declined in adults 20 years from 1999-2000 to 2015-2016 and low HDL cholesterol has declined from 2007-2008 to 2015-2016.
QuickStats: Infant Mortality Rate, by Urbanization Level — National Vital Statistics System, United States, 2007 and 2015October 20, 2017
In both 2007 and 2015, infant mortality rates were highest in rural counties (7.5 infant deaths per 1,000 live births and 6.8, respectively).
Rates were lower in small and medium urban counties (7.1 in 2007 and 6.4 in 2015) and lowest in large urban counties (6.4 in 2007 and 5.4 in 2015).
For all three urbanization levels, infant mortality rates were significantly lower in 2015, compared with rates in 2007.
Source: National Vital Statistics System, linked birth/infant death period files, 2007 and 2015.
Questions for Cheryl Fryar, M.S.P.H., Health Statistician and Lead Author on “Hypertension Prevalence and Control Among Adults: United States, 2015-2016”
Q: What made you decide to conduct this study on hypertension prevalence and control?
CF: The primary motivation for conducting this study was to offer the public updated data on U.S. adults who have high blood pressure. Every two years new data are available for us to provide updated estimates of hypertension prevalence and control. Data were recently released for the 2015-2016 National Health and Nutrition Examination Survey, and our next step was to analyze the data and provide accessible statistical information that might guide actions to improve the health of the American people.
Q: Was there a finding in your new study that surprised you, and if so, why?
CF: The findings were pretty consistent with what’s been previously reported. The prevalence of hypertension hasn’t changed much since 1999. Among those with hypertension, controlled hypertension increased between 1999 and 2010, and then has remained stable since that time. There was an observed decrease in hypertension control since 2013-2014, but this change was not statistically significant. It is too early to tell whether or not a change in hypertension control is occurring.
Q: What do you think is the most interesting demographic finding among your new study’s findings for 2015-2016 – age, race, sex?
CF: There are a number of interesting demographic findings in this report, and we still find disparities among demographic subgroups. Hypertension prevalence was highest among non-Hispanic black men and women. Hypertension also increases with age — from 7.5% in the youngest age group 18-39, to 63.1% in the oldest age group 60 and over.
On the other hand, among adults with hypertension, about half of adults 40 and over with hypertension had controlled hypertension compared to about a third of young adults. Overall, women with hypertension had higher controlled hypertension than men with hypertension.
Q: When you identified adults with controlled hypertension in your study, was that through participants’ self-reporting that they were on medication for high blood pressure or another method? If it was self-reporting, how do you know it’s true?
CF: One of the strengths of the National Health and Nutrition Examination Survey, or NHANES, is that it combines both interviews in the home and physical examinations in mobile examination centers, including blood pressure measurement. In order to identify people with controlled hypertension, we looked at the measured blood pressure of adults who were taking medication for their hypertension. If they had a measured systolic blood pressure reading < than 140 mmHg AND a diastolic reading of <90 mmHg, then their hypertension was considered controlled.
Q: What is the take-home message from this report?
CF: I think the take-home message of this report is that hypertension prevalence has remained unchanged since 1999 at around 29%, and that just under half of adults with hypertension have their hypertension under control. High blood pressure among U.S. adults is a persistent and prevalent concern that is a serious factor in the health and well-being of the nation. The statistics in this new report show that we have yet to meet the Heathy People 2020 Goal of 61.2% for hypertension control.
Fact or Fiction: Has the percentage of adults in the U.S. who are obese leveled off in the last several years?October 16, 2017
Source: National Health and Nutrition Examination Survey
Questions for Craig M. Hales, M.D., Lead Author on “Prevalence of Obesity Among Adults and Youth: United States, 2015–2016”
Q: There seems to be confusion about whether obesity is going up or is stable. Could you clarify based on your new data?
CH: The trends in obesity prevalence are different for adults 20 years and over than they are in youth 2-19 years. Since 1999-2000 there has been an increasing trend among adults. The prevalence of obesity was 30.5% among adults in 1999-2000 and has increased almost 10 percentage points to 39.6% in 2015-2016. Almost 4 in 10 adults had obesity in 2015-2016, and that is the highest prevalence of obesity ever reported among all US adults.
Among youth, there was a significant increase in obesity prevalence between 1999-2000 and 2015-2016, however, between 2003-2004 and 2013-2014 the prevalence was unchanged at 17% and there was no statistically significant change between 2013-2014 and 2015-2016. We are continuing to analyze trends in both youth and adults.
Q: Would it be accurate to say that, among adults at least, the percentage who have obesity hasn’t changed much in recent years, but has definitely increased over the past 10 or 15 years?
CH: The prevalence of obesity among adults has definitely increased since 1999-2000. Since 1999-2000 the prevalence has increased almost 10 percentage points from 30.5% to 39.6%, or almost 40%. From one 2-year cycle to the next, changes in obesity prevalence may appear small, but when we look over time, we are better able to see trends.
Q: Between adolescents, school-aged kids, and pre-schoolers, what are the most significant patterns among our youth, based on these new data?
CH: Among youth, these data show that school-aged kids and adolescents have a higher prevalence of obesity than pre-schoolers. This is the same pattern we have seen in previous reports from this survey.
Q: The U.S. has changed quite a bit demographically over the past 30 years, and this corresponds with large increases in the percentages who are obese. With obesity prevalence being significantly higher among U.S. Hispanics, would it be accurate to say that at least some of the increase in obesity prevalence in the U.S. is a characteristic of demographic change?
CH: It’s true that both non-Hispanic black and Hispanic adults have a higher prevalence than non-Hispanic whites and non-Hispanic Asians, although the patterns are different in men and women. Previous reports have found that trends over time are not explained by these demographic changes.
For this report we focused on a cross-section of the US population in 2015-2016, but we are continuing to analyze the data, including the impact of demographic changes on trends over time.
Q: What finding in your new report did you find most striking?
CH: What I found most striking is that almost 40% of adults in the US had obesity in 2015-2016. This is almost 10 percentage points higher than the prevalence was in 1999-2000. It is the highest prevalence of obesity ever reported among all US adults.
Q: What is the best advice for those who want to control their weight?
CH: I recommend that anyone who wants to lose weight talk to their healthcare provider. People can also learn more about US diet and physical activity guidelines at health.gov.
Q: Anything else you’d like to note about the new study?
CH: Measured height and weight is the gold standard for generating accurate estimates of obesity prevalence. The National Health and Nutrition Examination Survey is unique in that it combines both interviews in the home and physical examinations in mobile examination centers, and it is the only national survey where people’s height and weight are physically measured.
Other surveys report obesity prevalence based on self-reported height and weight, but several studies have found serious inaccuracies with self-reported or proxy-reported height and weight. Among adults and teens, self-reported height tends to be overreported and weight is underreported, although misreporting can vary among subgroups of the population – but this misreporting leads to underestimates of obesity prevalence.