The Vital Statistics Rapid Release program provides access to the timeliest vital statistics for public health surveillance, through 1) releases of Quarterly Provisional Estimates and 2) Special Reports based on a current flow of vital statistics data from state vital records offices.
Using the provisional data, NCHS produces much more timely estimates of important health indicators for public health practitioners, researchers, and health policy-makers than would be possible using final annual data.
CDC’s National Center for Health Statistics has updated its “Stats of the States” feature on the NCHS web site. This resource features the latest state-by-state comparisons on key health indicators ranging from birth topics such as teen births and cesarean deliveries to leading causes of death and health insurance coverage.
Tabs have been added to the color-coded maps to compare trends on these topics between the most recent years (2015 and 2014) and going back a decade (2005) and in some cases further back.
To access the main “Stats of the States” page, use the following link:
Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author on “Trends and Variations in Reproduction and Intrinsic Rates: United States, 1990-2014”
Q: Why did you conduct this study?
BH: We produced this report because we wanted to provide an updated analysis of fertility patterns in the United States. This report provides current detailed information on the fertility patterns for the United States, as measured by reproduction and intrinsic rates, which have not been available since the release of an earlier report more than a decade ago (https://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_17.pdf). The new report focuses on the recent trends in these rates and also presents, for the first time, reproduction and intrinsic rates for the three largest population groups — non-Hispanic white, non-Hispanic black, and Hispanic.
Q: What is the difference between reproduction rates and intrinsic rates, and what can they tell us about population growth and change in the United States?
BH: The reproduction and intrinsic rates are important to understanding population growth and change in the United States and are useful additions to the annual birth and fertility rates (such as the crude birth rate and general fertility rate) published by NCHS. Unlike the annual birth and fertility rates which measure the fertility of women in a given year, the reproduction rates summarize the number of births expected for a (hypothetical) group of 1,000 women over their lifetime given their particular fertility and mortality rates. The reproduction rates can measure, for example, whether the number of births is at “replacement,” that is, the level at which a given group of women can exactly replace themselves. For example, the net reproduction rate in 2014 was 897 which means that given their fertility and mortality rates in 2014, we would expect to see 897 daughters born per 1,000 of these women, which is below replacement level (1,000 daughters). The reproduction rates can be used to compare populations over time or among different groups. The intrinsic rates summarize the birth, death, and rate of change of a population, which would be expected to prevail given particular fertility and mortality rates. These rates measure the change of a population, either growth or decline, and can be used to compare populations over time or among different groups. For example, the intrinsic rate of natural increase in 2014 was -3.7, which means that given the fertility and mortality rates in 2014, the population for the United States was declining. This measure excludes migration.
Q: Was there a result in your study’s analysis of reproduction and intrinsic rates in the United States that you hadn’t expected and that really surprised you?
BH: The pervasive and large declines in the rates among the race and Hispanic origin groups was quite striking. For the three largest groups — non-Hispanic white, non-Hispanic black, and Hispanic– the total fertility, gross reproduction, and net reproduction rates declined by at least 7% from 2006 through 2014. The Intrinsic rate of natural increase declined by at least 78% from 2006 through 2014 for the three groups.
Q: What differences, if any, did you see among race and ethnic groups?
BH: While the total fertility, gross reproduction, and net reproduction rates and intrinsic rate of natural increase declined for the three race and Hispanic origin groups, there were differences among the groups in the rate of decline and among the rates themselves. In general, the reproduction rates declined the least for non-Hispanic white women and the most for Hispanic women from 2006 through 2014. Similarly, in 2014, the reproduction rates were lowest for non-Hispanic white women and highest for Hispanic women. The intrinsic rates of natural increase differed, too, with the rate being negative for both the non-Hispanic white and non-Hispanic black population groups in 2014, but positive for the Hispanic population group.
Q: What is the take home message of this report?
BH: The take home message from the report is that reproduction rates and intrinsic rate of natural increase have declined overall from 1990 through 2014 and for the three largest race and Hispanic origin groups from 2006 through 2014. However, differences in the reproductive and intrinsic rates for the groups exist.
Questions for Joyce A. Martin, M.P.H., Demographer, Statistician, and Lead Author on “Births: Final Data for 2015”
Q: Was there a result in your study’s analysis of births in the United States that you hadn’t expected and that really surprised you?
JM: Although small, (from 9.57% to 9.63%) the rise in the preterm birth rate (births of less than 37 completed weeks of gestation) was unexpected. This rate had been declining steadily since 2007.
Also of note is the decline in the triplet and higher-order multiple birth rate, down 9% from 2014 to 2015, and a decrease of 46% since 1998. The year 2015 also is the third straight year of declines in the rate of cesarean delivery (rate of 32.0% in 2015).
The continued, large decline in the teen birth rate (down 8% from 2014 to 2015) was also somewhat surprising, although not unprecedented. From 2007 through 2014, the teen birth rates had declined 7% annually.
Q: What is the difference between this new births report and the other reports your office produced on 2015 birth data, like the preliminary data report on 2015 births and the Data Brief on teen births?
JM: The annual report “Births: Final Data for 2015” offers substantially more detail (e.g., age, race and Hispanic origin of mother, state) on key topics, than does the report on preliminary birth statistics (“Births: Preliminary Data for 2015”). The final report also includes information on topics not included in the preliminary reports such as multiple births, attendant and place of birth, birth order and birth rates for fathers.
Q: How has the number of births in the United States changed in 2015 from previous years?
JM: The number of births in the United States declined slightly in 2015 (by 9,579 births to 3,978,497) from 2014. The decline for 2015 followed an increase in births for 2014, which was the first increase since 2007.
Q: What differences, if any, did you see among race and ethnic groups, and among various ages?
JM: Of continued concern are the higher risks of poor birth outcomes as measured by levels of preterm birth and low birthweight among non-Hispanic black mothers compared with total births and other race and Hispanic origin groups. For example, in 2015 the preterm birth rate for births to non-Hispanic black mothers was more than 50% higher at 13.41% than for non-Hispanic white women (8.88%) and nearly 50% higher than the rate for births to Hispanic mothers (9.14%).
Q: Did you observe any regional or state differences in this study on births?
JM: Differences by state were observed for many of the demographic and medical/health items included in the 2015 final birth report. For example, from 2014 to 2015, the general fertility rate–which is the number of births per 1,000 women aged 15–44–declined in eight states and was essentially unchanged in the 42 states and the District of Columbia (DC). In 2015, the general fertility rate ranged among states from 51.1 births per 1,000 women aged 15–44 in Vermont to 78.2 in South Dakota.
Also, increases in preterm birth rates were limited to four states from 2014 to 2015: Arkansas, California, Nebraska, and North Carolina. Rates declined in four states: Montana, New York, Texas and Wyoming. Nonsignificant differences were reported for the remaining states and DC.
NCHS has released provisional estimates of selected reproductive indicators from birth data for 2014 through the second quarter of 2016. Estimates for 2014 and 2015 are based on final data.
The estimates for the first and second quarter of 2016 are based on all birth records received and processed by NCHS as of August 28, 2016.
Estimates are presented for: general fertility rates, age-specific birth rates, total and low risk cesarean delivery rates, preterm birth rates and other gestational age categories. These indicators were selected based on their importance for public health surveillance as well as the feasibility of producing reliable estimates using available provisional data. Future quarterly releases will include additional birth indicators from natality data.
Quarterly estimates are compared with estimates for the same quarter of the preceding year; for example, the second quarter of 2016 is compared with the second quarter of 2015. For comparability with rates for 12-month periods, the quarterly (3-month) rates have been annualized to present births per year per 1,000 population that would be expected if the quarter-specific rate prevailed for 12 months.
In addition, the rates and percentages for a 12-month period ending with each quarter (i.e., 12-month moving average) are presented to account for seasonality. Estimates for the 12-month period ending with the fourth quarter in each year can be interpreted as an annual provisional estimate for that year.
Questions for Brady Hamilton, Statistician and Lead Author of “Teen Birth Rates for Urban and Rural Areas in the United States, 2007–2015”
Q: Are teen birth rates in the U.S. higher in urban areas or rural areas?
BH: The birth rate for teenagers is higher in rural areas than in urban areas. In 2015, the rate was 30.9 births per 1,000 females aged 15-19 for rural areas compared with 20.9 for urban areas. This difference persisted over the duration of the study, from 2007 through 2015, and was seen in the teen birth rates for non-Hispanic white, non-Hispanic black, and Hispanic females.
Q: What explains the differences or similarities in the two areas?
BH: The data on which the report is based comes from the birth certificates filed in all states and DC. While the data from the birth certificate provide detailed information on a number of topics, this report did not examine reasons for urban/rural differences, as information on many contributing factors is not available from the birth certificate.
However, the report shows that while the birth rate for teenagers is higher in rural areas than in urban areas, birth rates for all areas declined from 2007 through 2015, down 50% in large urban, 44% in medium and small urban, and 37% in rural areas.
Q: What were some of the regional differences you observed in teen birth rates in urban or rural areas?
BH: The urban teen birth rate declined for all states and DC between 2007 and 2015, with declines ranging from 24% for teens in North Dakota to 57% for teens in Arizona, whereas the rural teen birth rate declined for in nearly all states, with declines ranging from 18% for teens in Alaska to 73% for teens in Connecticut.
Among the urban areas, states with the largest declines (50% or more in the teen birth rate) include: Arizona, California, Colorado, Connecticut, Florida, Georgia, Maryland, Massachusetts, Minnesota, Mississippi, New Jersey, New Mexico, North Carolina, Rhode Island, Utah, Vermont, and Virginia.
Among the rural areas, states with the largest declines (50% or more in the teen birth rate) include: Colorado and Connecticut.
Q: Are there any data which suggests sexual activity among teens is higher in urban vs. rural areas – or vice versa?
BH: As noted, information is not available from the birth certificate on the attitudes and behavior of the parents associated with fertility and family formation.
Q: What are the differences in teen birth rates among race/ethnic groups and are there different patterns among these groups depending on whether they live in urban or rural areas?
BH: Teen birth rates for non-Hispanic white, non-Hispanic black, and Hispanic females were highest in rural counties and lowest in large urban areas in 2015.
For each area, the teen birth rate was consistently highest for Hispanic females and consistently lowest for non-Hispanic white females.
The difference in the teen birth rate between rural and large urban areas was lowest for non-Hispanic black females and greatest for non-Hispanic white females.
Q: Which U.S. counties have the highest teen birth rate and which counties have the lowest?
A: Teen birth rates are not available for individual counties in the report. Counties are grouped into areas according to their urban or rural designation and the teen birth rate was reported for an area based on the aggregated data of the counties for the area.