NCHS Releases Health, United States: 2018

October 30, 2019

National fertility rates have been declining steadily for over a decade, and life expectancy at birth has also declined in recent years, according to the latest annual report on the nation’s health, released today by CDC’s National Center for Health Statistics.

The report, “Health, United States: 2018” features charts and online tables of health-related data on a wide range of topics, including health care, immunization, and health behaviors, providing a comprehensive snapshot of the nation’s health:

  • Fertility rates (the number of live births per 1,000 females ages 15-44) have fallen 10 out of the last 11 years in the United States.
  • The birth rate among teenagers ages 15–19 years fell by more than one-half, from 41.5 in 2007 to 18.8 live births per 1,000 teens in 2017—a record low for the United States. 2018 data indicate that this trend has continued.
  • The infant mortality rate in the United States dropped in 2017, from 5.9 infant deaths per 1,000 live births in 2015 and 2016 to 5.8 in 2017. The infant mortality rate in the U.S. has declined by more than five-fold since 1950.
  • From 2007 to 2018 (preliminary estimates), the percentage of children under 18 years with no health insurance decreased 3.8 percentage points to 5.2%.
  • In 2017, fewer than half (48.5%) of uninsured children ages 19–35 months had received the recommended combined 7-vaccine series. This was significantly lower than among the percentage of children who were covered by private health insurance (76.0%) or Medicaid (66.5%).
  • The use of e-cigarettes among students in grades 9–12 increased from 1.5% in 2011 to 20.8% in 2018, nearly doubling (from 11.7% in 2017) in the last year alone.
  • In 2017, 16.2% of adults living below 100% of the poverty level delayed or did not receive needed medical care due to cost compared with 5.1% of those living at or above 400% of the poverty level.
  • The percentage of Americans taking 5 or more prescription drugs in the past 30 days increased from 6.5% in 1999–2000 to 10% in 2003–2004, and then was stable through 2015–2016 (11%).¹
  • In 2017, personal health care expenditures in the United States totaled almost $3.0 trillion—a 3.8% increase from 2016. • From 2007 to 2017, the death rate from drug overdoses increased 82%, from 11.9 to 21.7 deaths per 100,000.¹
  • From 2007 to 2017, the suicide rate for children ages 10–14 increased from 0.9 to 2.5 deaths per 100,000 resident population. From 2007 to 2017, the suicide rate increased 24%, from 11.3 to 14.0 deaths per 100,000 resident population.¹
  • Life expectancy at birth in the U.S., after increasing or remaining the same in every year between 1994 and 2014, has declined in two of the past three years. Significant decreases in life expectancy have been observed each year since 2015 among men, while remaining stable among women.

¹Rates are adjusted for age.

Regional Differences in the Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2017

October 25, 2019

NCHS report describes regional differences in the specific drugs most frequently involved in drug overdose deaths in the United States in 2017.  Data from the 2017 National Vital Statistics System–Mortality files were linked to electronic files containing literal text information from death certificates.

Key Findings: 

  • Among drug overdose deaths in 2017 that mentioned at least 1 specific drug on the death certificate, the 10 drugs most frequently involved included fentanyl, heroin, cocaine, methamphetamine, alprazolam, oxycodone, morphine, methadone, hydrocodone, and diphenhydramine.
  • Regionally, 6 drugs (alprazolam, cocaine, fentanyl, heroin, methadone, and oxycodone) were found among the 10 most frequently involved drugs in all 10 HHS regions, although the relative ranking varied by region.
  • Age-adjusted rates of drug overdose deaths involving fentanyl or deaths involving cocaine were higher in the regions east of the Mississippi River, while age-adjusted rates for drug overdose deaths involving methamphetamine were higher in the West.
  • The regional patterns observed did not change after adjustment for differences in the specificity of drug reporting.

QuickStats: Age-Adjusted Percentages of Adults Aged 18–64 Years Who Never Felt Rested in the Past Week by Sex, Race, and Hispanic Origin — National Health Interview Survey, 2017–2018

October 25, 2019

During 2017–2018, among persons aged 18–64 years, women were more likely than men to report they never felt rested in the past week overall (21.1% versus 14.3%) and in each race and Hispanic origin group.

Non-Hispanic white men (16.0%) were more likely to report they never felt rested than were Hispanic men (11.1%), non-Hispanic black men (12.0%), and non-Hispanic Asian men (9.7%).

Non-Hispanic white women (23.0%) were more likely to report they never felt rested than were Hispanic women (19.0%), non-Hispanic black women (18.9%), and non-Hispanic Asian women (13.7%).

Source: National Center for Health Statistics, National Health Interview Survey, 2017–2018. 

QuickStats: Percentage of Women Aged 50 Years or Older Who Have Had a Hysterectomy, by Race/Ethnicity and Year — National Health Interview Survey, United States, 2008 and 2018

October 18, 2019

The percentage of women aged 50 years or older who have had a hysterectomy decreased from 36.6% in 2008 to 31.7% in 2018.

Decreases were also observed among non-Hispanic white women (37.5% to 33.3%) and Hispanic women (30.3% to 22.6%), but there was no significant decrease for non-Hispanic black women (40.4% to 36.8%).

For both time points, non-Hispanic black and non-Hispanic white women were more likely than Hispanic women to have had a hysterectomy.

Source: National Health Interview Survey, 2008 and 2018 data.

Death Rates Due to Suicide and Homicide Among Persons Aged 10–24: United States, 2000–2017

October 17, 2019

Questions for Lead Author Sally Curtin, Health Statistician, of “Death Rates Due to Suicide and Homicide Among Persons Aged 10–24: United States, 2000–2017.”

Q: Why did you decide to focus on ages 10 through 24 for suicides and homicides?

SC: Suicide and homicide are among the leading causes of death for this age range.  As there are almost no suicides below the age of 10, we began with age 10 and decided to go through the young adults age range, through age 24.

Q: How did the data vary by age groups?

SC: For the 10-24 age range, rates of both suicide and homicide are lowest for 10-14, intermediate for 15-19 and highest for 20-24.  The patterns differed between age groups.  For children and adolescents aged 10-14, suicide rates nearly tripled from 2007 to 2017 whereas homicide rates gradually declined over the period.  For 15-19 and 20-24, both suicide and homicide rates increased, with the increase beginning earlier for the suicide rates.

Q: Is this the first time you have published a report on this topic?

SC: We have published some similar reports recently, but this is the first one which focuses on these two causes of death for this age range.  Suicide and homicide are often referred to as the two major components of violent death.

Q:  Was there a specific finding in your report that surprised you?

SC: That both suicide and homicide have increased recently for 15-19 and 20-24 year olds.  Homicide has only been increasing since 2014, but this is after years of decline whereas suicide began to increase sooner.

Q: Why do you think suicide and homicide death rates have risen?

SC: That is for others in the prevention and research community to answer.  However, other studies have shown that some of the risk factors for suicide and homicide have increased.  In particular, depression and other mental health disorders have been shown to be increasing in youth.

Updated Provisional Drug Overdose Death Data: 12-Month Ending from March 2018- March 2019

October 16, 2019


QuickStats: Birth Rates for Teens Aged 15–19 Years, by Age Group — National Vital Statistics System, United States, 1991–2018

October 11, 2019

The birth rate for teens aged 15–19 years declined from a peak of 61.8 per 1,000 females in 1991 to a record low of 17.4 in 2018.

The rate has declined more rapidly since 2007. From 2007 to 2018, the rate declined from 21.7 to 7.2 for teens aged 15–17 years and from 71.7 to 32.3 for teens aged 18–19 years.

Source: NCHS, National Vital Statistics System. Birth Data, 1991–2018.

Mortality Among Adults Aged 25 and Over by Marital Status: United States, 2010–2017

October 11, 2019

Questions for Lead Author Sally Curtin, Health Statistician, of “Mortality Among Adults Aged 25 and Over by Marital Status: United States, 2010–2017.”

Q: This study seems to confirm what other research has concluded, that married people tend to live longer.  Would that be a correct assumption?

SC:  Yes, many studies have found that married people have better health and live longer than unmarried people.   In this report, we are presenting age-adjusted death rates which clearly show that the rates are lower for married than never-married, divorced or widowed adults.  In addition, the age-adjusted death rate for married adults declined 7% over the period, the largest decline of any group.

Q: There are a lot of jokes and other narratives in pop culture that married life is far from ideal, and yet these results seem to at least suggest that there is one major positive outcome related to the institution.  Do you know why that is?

SC:  There has been much research over the years on the pathways through which marriage might work to result in better health outcomes.  In particular, researchers have explored the question of whether marriage is selective for good health or whether the institution itself is protective of health.  By selective, I mean that people who are healthier, or who have correlates of better health (e.g. more education, higher income), are more likely to marry.  This is true for the most part.  However, there has also been research that has shown that marriage is protective of health, particularly for men, because married people are more likely to have health insurance, and a spouse may encourage better lifestyle and health habits as well as assist in healthcare related activities (scheduling doctor’s appointments, etc…).  For example, a 2014 NCHS report found that among men with health insurance, those who were married were more likely than their unmarried counterparts (including those who were cohabiting) to seek preventive health services.

Q: Was this the first time you studied this topic?

SC: NCHS publishes age-adjusted death rates by marital status every year in their final death report.  However, this is the first specialized report on this topic in almost 50 years.

Q: Was there anything in the findings that were surprising?

SC: I think it was the fact that even though age-adjusted death rates are much lower for married adults, these rates declined 7% between 2010 and 2017.  This was the greatest decline of all groups–rates for never married persons declined by 2%, rates for divorced persons remained stable, and rates for widowed persons actually increased, by 6%.

Q: The patterns seem pretty consistent among men and women.  Was there anything that you found between the genders that was inconsistent?

SC: Both men and women had 7% declines in the age-adjusted death rate for married persons.  However, for men, the other groups remained relatively stable from 2010 to 2017.  For women, those who were divorced had stable death rates but never-married women had a decline of 3% while widowed women had a 6% increase.

Q: Anything else you’d like to add?

SC:  Just that the next step is to look at these findings by selected causes of death to determine whether the lower death rates for married adults are broad across most of the leading causes or contained to a few specific causes.

Fact or Fiction: Are death rates for married people in the U.S. lower than the rates for unmarried people?

October 10, 2019

Source: National Vital Statistics System, 2010-2017

Breast Cancer Screening Among Women by Nativity, Birthplace, and Length of Time in the United States

October 9, 2019

Questions for Lead Author Tainya Clarke, Health Statistician, of “Breast Cancer Screening Among Women by Nativity, Birthplace, and Length of Time in the United States.”

Q: Why did you decide to do a report on mammography screening among women by nativity?

TC: There is currently limited published research on how nativity, birthplace and/or lifetime in the US of ethnically diverse foreign-born women affect the likelihood of having a mammogram.

Q: How did the data vary by nativity, birthplace and lifetimes in the United States?

TC: Foreign-born women were less likely than US-born women to have ever had a mammogram. If evaluated on equal standing for selected sociodemographic factors e.g. income, education, marital status; foreign-born women residing in the United States for less than 25% of their lifetime were as likely as US-born women to have met the U.S. Preventive Services Task Force (USPSTF) recommendations, while those residing in the United States for 25% or more of their lifetime were more likely to do so than US-born women.

Q: Was there a specific finding in your report that surprised you?

TC: Yes, we found that after controlling for the sociodemographic factors examined in this research, foreign-born women from some countries such as Mexico, and Central America were more likely to have received mammogram compared with US-born women.

Q: How did you obtain this data for this report?

TC: The data was obtained from the National Center for Health Statistics NCHS and most of the information used are publicly available. Information such as country of birth and year of immigration may be obtained through the CDC’s Research Data Center (RDC) by submitting a proposal stating the reason for use.

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

TC: Length of lifetime in the US among foreign-born women have some positive affect on the likelihood of having a mammogram among foreign-born women. However, analyses indicate that the absence of some sociodemographic factors such as health insurance coverage, usual place for medical care, and poor standing in some factors such as educational attainment, seeing a doctor in the past year and income, also play a role in the likelihood of getting a mammogram among foreign-born women.