A Demographic, Attitudinal, and Behavioral Profile of Cohabiting Adults in the United States, 2011–2015

May 31, 2018

Questions for Colleen Nugent, Statistician, and Lead Author of “A Demographic, Attitudinal, and Behavioral Profile of Cohabiting Adults in the United States, 2011–2015

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

CN: We took a snapshot of adults aged 18-44 in 2011-2015 and see that demographically, attitudinally, and behaviorally, cohabiters represent a unique group.  Demographically, one interesting finding is that cohabiters have lower educational attainment than other marital status groups–current cohabiters were more likely than both currently married and unmarried, noncohabiting men and women to have not received a high school diploma or GED.  Cohabiting men and women also hold different attitudes when it comes to fertility and family formation.

One interesting finding here is that a higher percentage of cohabiting women and men agreed with the statement, “It is okay to have and raise children when the parents are living together but not married,” compared with both married and unmarried, noncohabiting individuals.

In terms of family-formation and fertility behaviors, an interesting finding is that a higher percentage of cohabiting men and women had their first sexual intercourse before age 18 than both married and unmarried, noncohabiting persons.


Q: Why is the CDC examining trends in cohabitation in the U.S.?

CN: We aren’t examining trends because we don’t compare any estimates to a prior point in time.  But we felt it was important to profile cohabiters because cohabiting is becoming more prevalent among U.S. adults, and births to unmarried women are most likely to happen in a cohabiting union.


Q: Were there any major differences between men and women on attitudes and fertility behavior involving cohabitation?

CN: We only directly compared male and female cohabiters in our report.  Men and women only differed on one attitude–“It is okay for an unmarried female to have and raise a child.”  Female cohabiters were more supportive of this situation than male cohabiters.  Female cohabiters were more likely than male cohabiters to be living with children under 18, but less likely than male cohabiters to have had an unintended birth.


Q: Is there any comparable trend data on cohabitation in U.S. older than 2011-2015 data?

CN: Past NSFG surveys have collected data on cohabitation, but we did not analyze the older data for this report.  Other published estimates using older data incorporate a wider age range of respondents (15-44 years), so we can’t directly assess the trend using these newer estimates based on adults 18-44 in 2011-2015.


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

CN: Cohabiting adults represent a unique group relative to married or other unmarried adults and thus may have distinct family planning and fertility needs and considerations.

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Timing and Adequacy of Prenatal Care in the United States, 2016

May 30, 2018

Questions for Michelle Osterman, Statistician, and Lead Author of “Timing and Adequacy of Prenatal Care in the United States, 2016

Q: What do you feel was the most significant finding in your analysis?

MO: Overall more than 3 out of 4 women are receiving prenatal care in the first trimester of pregnancy, but this varies by race and Hispanic origin.


Q: Did you find anything surprising about the findings?

MO: The wide variation in first trimester prenatal care between race and Hispanic origin groups among different sources of payment for the delivery (Supplemental Tables 1 and 2).


Q: How has the percentage of mothers who received adequate prenatal care changed over the years?

MO: Trends were not analyzed in this report because 2016 is the first year for which national data on prenatal care is available. Provisional 2017 data show that the percentage of women receiving prenatal care in the first trimester increased to 77.3%


Q: Do you have any insight as to why some groups of women seem to be less likely to have at least adequate prenatal care and/or start their care in the first trimester?

MO: Differences in utilization and initiation may be due to differences in access and resources.


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

MO: Healthy People 2020, a set of national health objectives for the country, includes a goal for prenatal care.  The goal for 2020 is for 77.9% of pregnant women to receive prenatal care in the first trimester of pregnancy, a target only about 1% higher than the national level of 77.1% we are reporting in this analysis. This target may be achievable for the United States as a whole, but may be less achievable for certain subgroups.


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. https://www.cdc.gov/nchs/nsltcp/index.htm.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6717a6.htm