Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2017

May 22, 2018

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2017

Q: What were some of the major findings in your full-year 2017 health insurance estimates?

RC: In 2017, 29.3 million persons were uninsured at the time of interview. This is 19.3 million fewer persons than in 2010. In 2017, 9.1% were uninsured, 36.2% had public coverage, and 62.6% had private coverage at the time of interview.

Q: What are the trends among race and ethnicity groups who were uninsured in 2017 and compared over time?

RC: In 2017, 27.2% of Hispanic, 14.1% of non-Hispanic black, 8.5% of non-Hispanic white, and 7.6% of non-Hispanic Asian adults aged 18–64 lacked health insurance coverage at the time of interview.

Significant decreases in the percentage of uninsured adults were observed from 2013 through 2017 for Hispanic, non-Hispanic black, non-Hispanic white, and non-Hispanic Asian adults.

Hispanic adults had the greatest percentage point decrease in the uninsured rate from 2013 (40.6%) through 2016 (25.0%). The observed increase among Hispanic adults between 2016 and 2017 (27.2%) was not significant.

Q: What does your data show this year for Americans who have high-deductible health insurance plans compared to previous years?

RC: In 2017, 43.7% of persons under age 65 with private coverage were enrolled in a high-deductible health plan (HDHP). Enrollment in HDHPs has increased 18.4 percentage points from 25.3% in 2010 to 43.7% in 2017. More recently, the percentage enrolled in an HDHP increased from 39.4% in 2016 to 43.7% in 2017.

Q: What do you see in state-level estimates of health insurance coverage this year?

RC: Among the 18 states presented in this report, there were no significant changes in the percentages of uninsured among persons aged 18–64 between 2016 and 2017.

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

RC: The take-home message from this report is found in the number of Americans who no longer lack health insurance. In 2017, 29.3 million (9.1%) persons of all ages were uninsured at the time of interview. This estimate is not significantly different from 2016, but there are 19.3 million fewer uninsured persons than in 2010.



Births: Provisional Data for 2017

May 17, 2018

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2017

Q: What did you think was the most interesting finding in your new analysis?

BH: The report includes a number of very interesting findings. The general fertility rate, 60.2 births per 1,000 women aged 15–44, declining 3% in 2017 and reaching a record low is certainly noteworthy. In addition, the continued decline in the birth rate for teens, down 7% from 2016 to in 2017, and reaching another record low, is very significant. The increase in the cesarean delivery rate following several years of decline is noteworthy as are the recent increase in rates of preterm and low birthweight births.

Q: Why does fertility keep going down in the U.S.?

BH: In general, there are a number of factors associated with fertility. The data on which the report is based comes from the birth certificates registered for births in the U.S. While the scope of this data is essentially all births in the country, and provides detailed information about rare events, small areas, or small population groups, the data does not provide information about the parent’s decision to have (or not have) a child. And so, accordingly, we cannot examine the “why” of the changes and trends in births.

Q: Does the decline in the Total Fertility Rate essentially mean fertility is down below “replacement” levels?  Could you explain this in general terms?

BH: “Replacement” refers to a minimum rate of reproduction necessary for generation to exactly replace itself, that is, enough children born to replace a group of 1,000 women and their partners. For the total fertility rate, this rate is generally considered to be 2,100 births per 1,000 women. In 2017, the total fertility rate, 1,764.5 births per 1,000 women, was below replacement.

Q: Do the increases among women over 40 suggest a “new norm” in people waiting till much later to have children?

BH: Birth rates for women aged 40-44 and 45-49 years have increased generally over the last 3 decades. Given this, it reasonable to expect this trend to continue.

Q: Are the annual declines in teen pregnancy something that we are in danger of taking for granted?

BH: The birth rate for females aged 15-19 has decreased 8% per year from 2007 through 2017. For comparison, the decline in the birth rates for women aged 20-24 and 25-29 was 4% and 2% from 2007 through 2017. The decline in teen births is very noteworthy.

Q: Can you explain how the increases in preterm births and low birthweight are connected?

BH: Infants born preterm are also often, but not exclusively, born low birthweight and vice-versa.  The causes of the recent upward shift in these rates are not well understood.

QuickStats: Percentage Distribution of Long-Term Care Staffing Hours by Staff Member Type and Sector — United States, 2016

May 4, 2018

In 2016, aides provided more hours of care in the major sectors of long-term care than the other staffing types shown. Aides accounted for 59% of all staffing hours in nursing homes, compared with licensed practical or vocational nurses (21%), registered nurses (13%), activities staff members (5%), and social workers (2%).

Aides accounted for 76% of all staffing hours in residential care communities, in contrast to activities staff members (10%), registered nurses (7%), licensed practical or vocational nurses (6%), and social workers (1%).

In adult day services centers, aides provided 39% of all staffing hours, followed by activities staff members (30%), registered nurses (15%), licensed practical or vocational nurses (9%), and social workers (6%).

Source: National Study of Long-Term Care Providers, 2016.