NCHS Releases Latest Provisional Drug Overdose Data

June 16, 2021


NCHS released the latest monthly preliminary counts of drug overdose deaths in the United States, covering the one-year period ending in November of 2020.  The data is now available in a web-based interactive dashboard at:

Provisional data show that the reported number of drug overdose deaths occurring in the United States increased by 28.9% from the 12 months ending in November 2019 to the 12 months ending in November 2020, from 70,357 to 90,722. After adjustments for delayed reporting, the predicted number of drug overdose deaths showed an increase of 29.4% from the 12 months ending in November 2019 to the 12 months ending in November 2020, from 71,672 to 92,751.

The reported number of opioid-involved drug overdose deaths in the United States for the 12-month period ending in November 2020 (67,574) increased from 49,488 in the previous year. The predicted number of opioid-involved drug overdose deaths in the United States for the 12-month period ending in November 2020 (69,287) increased from 50,504 in the previous year.

PODCAST: The 2020 Increase in Death Rates Were The Highest Ever Recorded

June 11, 2021


podcast-iconHOST:  Each quarter NCHS releases provisional data on mortality from leading causes of death in the U.S. on an interactive web-based dashboard.   This week the dashboard was updated to include Quarter 4 data from 2020 and gives a complete account of provisional death rates in the U.S. for the year.  Joining us to discuss some of the key findings is Farida Ahmad of the Division of Vital Statistics.

HOST: First question: how much did the death rate in the U.S. increase in 2020?

FARIDA AHMAD:  The death rate for the U.S. increased by about 16% in 2020 compared to 2019-

HOST:  Now is it safe to say that almost all of the increase can be attributed to COVID-19.

FARIDA AHMAD:  A large part of it, yes, but we also saw increases in other causes of death like heart disease, Alzheimer’s disease, and diabetes.  Unintentional injuries like drug overdose also increased throughout 2020.  This report only includes drug overdose rates for the first half of the year but you do see very large increases in the second quarter of 2020.

HOST:  Some say that certain causes of death like influenza and pneumonia declined in 2020 due to COVID – is that true?

FARIDA AHMAD:  No, not really – that’s due to influenza and pneumonia were actually higher in 2020 than in 2019.  That’s likely driven by the pneumonia more so than influenza though.

HOST:  Is there any sense whether some of those pneumonia deaths are miscategorized, that maybe they should be in the COVID category?

FARIDA AHMAD:  Yes, you know it’s definitely possible.  We don’t have hard numbers on that and to account for maybe miscategorized COVID deaths we would we would look at excess mortality.  So a different kind of measure to look at that.

HOST:  I guess then the same would be true for other causes of death, particularly those that occur at the very beginning of 2020.  Is there any chance there will be more COVID deaths added to the tally?

FARIDA AHMAD:  It’s certainly possible but we haven’t closed out the 2020 data year.  So we could still get additional changes but we don’t anticipate a significant number of deaths data will change.

HOST:  So the data aren’t final yet is that correct?

FARIDA AHMAD:   Yes that’s correct.

HOST:   So what are some of the more striking changes you saw in the death rates from 2019 to 2020 as far as certain leading causes go?

FARIDA AHMAD:  Diabetes deaths increased by almost 14%… Chronic liver disease increased by 17% … and then hypertension and Parkinson disease those increased by 12% and 11% respectively.

HOST:  So in a normal year those would be considered very large increases is that correct?

FARIDA AHMAD:  Yes, yeah shifts that large would be notable.

HOST: But there’s no way to sort of link that back to the pandemic, either directly or indirectly?

FARIDA AHMAD:   Not with the death certificate data that we have, unless these deaths – you know these deaths which were the underlying cause is what we’re looking at.  For these deaths COVID-19 might also be listed on the death certificate, in which case you could say that COVID-19 played a role in that death but otherwise we wouldn’t necessarily know if it was a direct or indirect cause of the pandemic in terms of disrupted access to healthcare or other contributing factors.  The death certificate data wouldn’t necessarily tell us that.

HOST: So in general 2020 was a very rough year for mortality but were there any declines in leading causes of death in 2020?

FARIDA AHMAD:  There were a few – there were declines in cancer, in chronic lower respiratory diseases, and pneumonitis due to solids and liquids>

HOST: Did the pandemic – did COVID-19 — have any impact on death rates at the state level?  Were there any unusual changes in 2020?

FARIDA AHMAD:  West Virginia and Mississippi had the highest death rates overall, but the largest increases in death rates were actually seen in New York and New Jersey.

HOST:  Is there anything else in this new data that you’d like to note?

FARIDA AHMAD: What this report allows us to look at is not just the deaths due to COVID-19, which have been understandably a huge focus of public health surveillance in last year, but with this report we get to look at some of the other leading causes of death that might not be in the top five, or the top ten, but these are issues of public health importance and concern.  To look at these various diseases and causes of death, so I think that’s really what this report adds is to be able to take a broader look.


HOST: Our thanks to Farida Ahmad for joining us on this edition of “Statcast.”

HOST:  On Wednesday of this week, NCHS also released a new report on screening for breast, cervical and colorectal cancer.  The study featured data on women age 45 and over from the National Health Interview Survey, and concluded that regular cancer screening is much more likely among women of higher socio-economic status, as well as women who are married or living with a partner, and women who engage in healthy behaviors — such as not smoking, regularly exercising, and getting a flu shot.

QuickStats: Percentage of Children† Aged 2–17 Years Who Wear Glasses or Contact Lenses, by Sex and Age Group — National Health Interview Survey, United States, 2019

June 11, 2021


In 2019, 25.3% of children aged 2–17 years wore glasses or contact lenses, and the percentage increased with age among both boys and girls.

Among boys, 3% wore glasses among those aged 2–5 years, 20.0% among those aged 6–11 years, and 35.3% among those aged 12–17 years. Among girls, the corresponding percentages are 3.1, 26.4, and 48.2.

The percentage was higher among girls than boys overall and among those aged 6–11 years and 12–17 years, but not in the youngest age group.

Source: National Center for Health Statistics, National Health Interview Survey, 2019.

Patterns of Mammography, Pap Smear, and Colorectal Cancer Screening Services Among Women Aged 45 and Over

June 9, 2021

NHSR157_SampleQuestions for Yelena Gorina, Health Statistician and Lead Author of “Patterns of Mammography, Pap Smear, and Colorectal Cancer Screening Services Among Women Aged 45 and Over.”

Q: Why did you decide to focus on screening for breast, cervical, and colorectal cancers in women?

YG: I was thinking about this topic since many years ago my step-father who was a gastroenterologist, introduced me to one of his patients who he saved by removing pre-cancerous polyps from her colon.  He was the first one who told me that colon cancer was 90% preventable if the screening would be done on a regular basis.

Q: Can you summarize how the percentage of cancer screenings varied by age groups?

YG: The percentage of cancer screenings varies by age and type of cancer and generally follow The U.S. Preventive Services Task Force recommendations. Percentage of colorectal cancer screening increase from 34% at age 45-54 to 72% at age 75-84 and then drop to 47% at age 85 and over. Percentage of mammography remains about 70% between age 45 and 84 and drops to 31% among those aged 85 and over. Percentage of cervical cancer screening decreases with age gradually from 78% among women 45–54 to 14% among those aged 85 and over.

Q: Do you have trend data for previous years?

YG: The objective of our report was to assess differences in screening for colorectal, breast, and cervical cancers by various characteristics using the data available for 2015 and 2018 National Health Interview Survey. status, behavioral factors, and health care utilization among noninstitutionalized civilian women aged 45 and over. The estimates from the National Center for Health publication Health US 2019 show that prevalence of mammography among women aged 50 and over remains about 65% since 2005;  use of Pap smears among women aged 18+ decreased from 78% in 2005 to 68% in 2018 45-64; and percentage of screening for colorectal cancer among women 50-75 increased from 44% om 2005 to 67% in 2018.

Q: Was there a specific finding in the data that surprised you from this report?

YG: A specific findings that surprised me in our report was Non-Hispanic white and black women aged 45-64 are more likely to be screened for breast cancer compared with Hispanic and non-Hispanic Asian women, and that 30% of non-Hispanic Asian women aged 65 and over received no screening for any of the three types of cancer, two times more compared with Hispanic and Non-Hispanic white and black women of the same age.

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

YG: We would like the readers note the disparities in the percentage screened for vulnerable groups of women, especially those with insurance and those without, those with more education and/or poor and those who had more education and not in poverty, and those who live in more rural area and those who live in the metropolitan statistical area.

NCHS Releases Latest Quarterly Provisional Mortality Data Through Full-Year 2020

June 8, 2021

NCHS has released the latest quarterly provisional mortality rates for the U.S., through full-year 2020 for most causes of death. 

Estimates are presented for 15 leading causes of death plus estimates for deaths attributed to coronavirus disease 2019 (COVID-19), drug overdose, falls for persons aged 65 and over, firearm-related injuries, human immunodeficiency virus (HIV) disease, and homicide. 

The data is featured on an interactive web site dashboard at:

NCHS has also released state maps showing COVID-19 death rates for provisional quarter 4 mortality data. You can access the 12-month ending map here and quarterly map here.

QuickStats: Percentage of Adults Who Are Very Worried About Ability to Pay Medical Bills if They Get Sick or Have an Accident, by Home Ownership and Age Group — National Health Interview Survey, United States, 2019

June 4, 2021

In 2019, 22.6% of renters were very worried about their ability to pay their medical bills if they get sick or have an accident, compared with 13.4% of homeowners.

For each age group, renters were more likely than homeowners to be very worried about paying their medical bills: 20.0% compared with 12.9% among those aged 18–39 years, 29.4% compared with 16.8% among those aged 40-64 years, and 16.1% compared with 8.0% among those aged 65 years or older.

Source: National Health Interview Survey, 2019.

PODCAST: Drug-Related Deaths Among U.S. Infants

June 4, 2021


HOST: Drug abuse in the United states has taken a devastating toll on society.  Nearly 92,000 Americans died of a drug overdose in the one-year period ending in October 2020, according to recent provisional data.  Over 823,000 Americans have died of an overdose since the year 2000.  Along the way, there’s been a great deal of collateral damage from drug abuse as well.  One topic that researchers have been exploring is the impact of the drug epidemic on fertility in the country, and this week NCHS released a study on drug-related infant deaths over a three-year period.podcast-icon

Joining us today is the author of that new report, Danielle Ely, from the NCHS Reproductive Statistics Branch.

HOST:  In your report, how did you define drug-involved infant deaths?

DANIELLE ELY:  For our report, we used a pretty standard definition of drug involvement.  Drug-involved infant deaths are those deaths that were due to drug involvement as either the underlying or a contributing cause of death.  So for infants, this means the death could occur due to accidental or unintentional ingestion of select prescription, illicit, or non-medical use of drugs. It could also include death due to maternal use of drugs, and it could include other cases where drugs were indicated with the death.

HOST:  How common are drug-related infant deaths?

DANIELLE ELY:  Well thankfully, these drug related infant deaths are relatively uncommon.  So in our study – and granted we were only looking at a select type of prescription, illicit or non-medical use drugs — but less than 1% of infant deaths from 2015 through 2017 were drug-related.

HOST:  You looked at three years of data – is there any sense of whether this has increased or declined over time?

DANIELLE ELY:  One of the reasons we were interested in doing this research is because nearly all of the research on drug deaths focuses on adults.  And so to our knowledge, this is the first report that really identifies drug involved infant deaths.  Because of that we can’t really say if there’s been an increase or decrease – the numbers are so small, even for those three years.  But what we do know is that drug overdose deaths for adults tripled from 1999 to 2017 so it’s very possible that over time infant drug involved deaths would have a similar pattern of increase, but we don’t have the data or the research completed to be able to say that for sure.

HOST:  So which drugs are most likely to be involved in these deaths?

DANIELLE ELY:  The drugs that were most frequently mentioned on the death certificate literal fields that we reviewed were methamphetamine, opioids, opioid treatment drugs like methadone or naloxone, as well as cocaine and cannabis or cannabinoids.

HOST:  Is that exclusively those drugs or could they be in combination with one or more drugs?

DANIELLE ELY:  There were many records that had multiple drugs mentioned – and those aren’t the only drugs that were involved with the infant drug-related deaths.  However, those were just the most frequently mentioned. There were also cases of, I believe it was benzodiazepines and hallucinogens – a few others I believe – but different stimulants.

HOST:  What complications in these infants most often lead to death?

DANIELLE ELY:  It’s really hard to say if there are specific complications that lead to death.  However, one of the things that we did look at in the report were those drug-involved deaths that we consider drugs as the underlying cause of death and those that we consider drugs of contributing cause of death.  So the most common cause of death for infants with drug involvement as an underlying cause of death would have been the newborn was affected by maternal use of drugs of addiction.  And for that there were just under 90 instances – infants that died with that as the underlying cause of death.  So for those cases where drugs were considered a contributing cause of death, “newborn affected by other forms of placental separation and hemorrhage” was the most common cause of death.  And for that there were 43 infants that died with that underlying cause of death.

HOST:  What type of characteristics are most common among mothers in these deaths?

DANIELLE ELY:  Compared with mothers of infants who died from all other causes, compared with the infants who died from drug-involved causes, their mothers were more likely to be non-Hispanic white, mothers were also more likely to be age 35 to 39, have lower educational attainment so they might have a high school degree or less, the mothers whose infants died of drug-involved causes were also more likely to use Medicaid as the source payment for delivery, and they were less likely to receive prenatal care, so they received late or no prenatal care at all compared with the mothers of infants who died from all other causes.

HOST:  And what about geography, in particular the urban-rural breakdown.  Do we have any sense of what any sort of geographic differences there are?

DANIELLE ELY:  We didn’t look at rural-urban differences, largely because there were so few infant deaths to begin with it didn’t necessarily lend itself to looking at a range of rural-urban areas.

HOST:  Are there any data to determine how many of the mothers were addicted to drugs versus those who just use drugs recreationally?

DANIELLE ELY:  That’s very complicated. I know I mentioned before the most common cause of death being the newborn affected by maternal use of drugs of addiction.  We don’t have the data that has information on the type of drug use of the mother, so we don’t know how many of these mothers may have been addicted drugs or those who use recreationally or on occasion.

HOST:  I think it’s important to at least introduce that just so people don’t run in one direction or another.  Are there any other data on adverse effects among infants mothers who use drugs during pregnancy but who survive?

DANIELLE ELY:  A few states do collect data on “neonatal abstinence syndrome” and neonatal abstinence syndrome is a range of effects of drug withdrawal, and particularly that from opioids for infants after birth, but there really is no national data that I am aware of on all of the potential adverse effects for infants of mothers who use drugs during pregnancy or for all drugs or the outcomes.

HOST:  And in any case you didn’t tackle that in this report.

DANIELLE ELY:  Certainly not – that is beyond the scope of our data.

HOST: What can be done to reduce or prevent this type of tragedy?

DANIELLE ELY:  Really, the first step in reduction or prevention of any type of infant death is to identify a potential problem and the risk factors that might also be related to that problem.  Really, that’s what we were trying to do with this report.  As I mentioned before, nearly all research has been focused around drug deaths for adults rather than infants, so we were really trying to find if there is a problem here, and if there are cases, which we found, which infants might be more likely to be impacted or rather to say which mothers or families might be in circumstances where this could be a potential problem.

HOST:  I guess I’ll ask you then – is there anything about your report, any findings in your report that we didn’t talk about that you’d like to mention?

DANIELLE ELY:  I think the biggest thing to take away from this would be that there are drug-involved infant deaths, but thankfully it is a relatively small number and we know that while some states have programs to help mothers who might have addiction or be using drugs, that not all mothers are able to necessarily get help during their pregnancy or after.  So those who have expertise with drug use, and maternal drug use in particular, might be able to take some of this to determine appropriate policies or interventions.

HOST:  Our thanks to Danielle Ely for joining us on this edition of “Statcast.”