Urban and Rural Variation in Fertility-related Behavior Among U.S. Women, 2011–2015

January 9, 2018

Questions for Kimberly Daniels, Ph.D., Statistician and Lead Author of “Urban and Rural Variation in Fertility-related Behavior Among U.S. Women, 2011–2015.”

Q: Why did you decide to examine fertility-related behavior among U.S. women in urban and rural areas?

KD: We decided to examine fertility-related behavior among U.S. women based on urban and rural residence because while there are many National Survey of Family Growth (NSFG) reports on fertility, they do not usually include information about place of residence.  Two NCHS reports were recently published that use Vital Statistics data from birth certificates and focus on urban and rural differences.

One of those reports was on urban and rural differences in infant mortality rates and the other on urban and rural differences in teen birth rates.  After seeing the differences shown in those reports, we decided to work on an NSFG report focusing on fertility-related behavior and place of residence.


Q: Are there any findings among the urban-rural differences that surprised you?

KD: As far as what findings in this report surprised me, based on other publications we reviewed before starting this report I expected that the percentage of currently married women would be higher in rural areas compared with urban areas.  The results in this report showed that the percentage of women who were currently married in each area was similar, around 40%.  I also expected that there would be a difference for cohabitation; although I am not sure which group I expected would be higher.

The results for age at first sexual intercourse may be surprising to readers of the report.  This report uses data from women ages 18-44.  Place of residence is measured at the time of interview.  Among adult women who have ever had sex, the average age at first sexual intercourse was lower for women living in rural areas, 16.6 years on average, compared with 17.4 for women living in urban areas.


Q: Do you have any older trend data to this report from the National Survey of Family Growth for urban and rural fertility-related behavior?

KD: As far as trends over time, we do not show trend data in this report on urban and rural variation in fertility-related behavior.  Some older NSFG reports do include that information, such as this one on fertility, family planning, and reproductive health using 2002 data.  The variable that classifies women as living in an urban or rural area is available on our public use datasets.  It is available to download from our website so researchers could examine time trends or differences in other topical areas by place of residence.


Q: What did your report find on contraceptive use among women in urban and rural areas?

KD: The report looked at contraceptive method use at last sexual intercourse among women ages 18-44 who had sex in the last 12 months.  Contraceptive methods were grouped into four categories based on effectiveness at preventing pregnancy; no method, a less effective method, a moderately effective method, and a most effective method.  The results showed that similar percentages of women in urban and rural areas used no method of contraception, 21.0%.  A higher percentage of women in urban areas used a less effective method, such as a condom, compared with women in rural areas.  A higher percentage of women in urban areas also used a moderately effective method, such as the oral contraceptive pill, compared with women in rural areas.  A higher percentage of women in rural areas used one of the most effective methods of contraception such as a sterilizing operation or an intrauterine device compared with women in urban areas.

As we note in the report, the percentages we show for contraceptive use and the other measures do not account for other factors that could play a role.  For example, the figure that describes differences in number of births shows that women in rural areas are more likely to have had any births and have a higher average number births.  So, some of the differences in contraceptive use across the two groups could be related to differences in plans for future childbearing.


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

KD: The takeaway messages are shown in the key findings and summary in the report.  Among women aged 18-44, on average, women living in rural areas had their first sexual intercourse at younger ages than women living in urban areas. Similar percentages of women in urban and rural areas were currently married, cohabiting, or never married. A higher percentage of women living in rural areas were formerly married compared with women in urban areas. Women living in rural areas were more likely than women living in urban areas to have had any births and had a higher average number of births. Among women aged 18–44 who had sexual intercourse in the past year, a higher percentage of women living in rural areas used one of the most effective methods of contraception at their last intercourse compared with women in urban areas.  It is important to remember that place of residence was measured at the time of interview.

Some of the outcomes in the report occurred when the woman lived in another geographic location.  Also, as I mentioned above the results do not account for other factors that could play a role in the urban and rural differences presented in the

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Stat of the Day – November 30, 2017

November 30, 2017


Births in the United States, 2016

September 27, 2017

Questions for Joyce A. Martin, M.P.H., Demographer, Statistician, and Lead Author on “Births in the United States, 2016.”

Q: How have birth rates changed in 2016 among different age groups?

JM: In general, births rates for women aged under 30 declined in 2016, whereas rates for women 30 and over rose. By age group, however, the change in rates changed differed considerably. The birth rates for teens aged 15-19 declined 9% from 2015 to 2016, whereas the rates declined 4% for women aged 20-24 and 2% for women aged 25-29. For women aged 30 and over, rate rose 1% for women aged 30-34, 2% for women aged 35-39, and 4% for women aged 40-44. As a result of the rise in the birth rate for older women, women aged 30–34 have for the first time in 2016 a higher birth rate than women aged 25–29.


Q: What did your report find on the trends for triplet and higher order multiple births?

JM: The rate of triplet and higher order multiple births was 101.4 per 100,000 total births in 2016, down 48% from the peak in 1998.


Q: Was there anything in the 2016 birth data that surprised you?

JM: The continued decline in birth rates among women under age 30 and the continued increase in the preterm birth rate which rose for the second straight year to 9.85% in 2016.  This rate had been on the decline from 2007 to 2014.


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

JM: The report documents a continuation of recent trends in several key birth measures in the United States.  Most notably, continued declines in childbearing among women under 30 years of age, continued declines in the cesarean delivery rate and increases in the preterm birth rate.


Q: When do you expect the Final 2016 Births report will be released?

JM: We expect the report to be released late this year or in early 2018.


Quarterly Provisional Estimates for Selected Birth Indicators, 2015—Quarter 1, 2017 Quarterly Provisional Estimates of Infant Mortality, 2014—Quarter 3, 2016 Vital Statistics Rapid Release from the National Vital Statistics System

August 8, 2017

Lauren_RossenQuestions for Lauren Rossen, Ph.D., Health Statistician and Lead Author of “Quarterly Provisional Estimates for Selected Birth Indicators”and “Quarterly Provisional Estimates of Infant Mortality

Q: What findings in your new data analyses on births and infant mortality most surprised you and why?

LR:  These latest quarterly provisional estimates suggest that the steady decline in teen birth rates that we have seen over the past several years is continuing into 2017, which is good news. What is of concern is the recent uptick in preterm birth rates, a trend that emerged in 2015 and that has unfortunately continued into 2016 and early 2017.


Q: What is the difference between the Rapid Release provisional estimates on births released today and the report from your office released last month, “Births: Provisional Data for 2016”? And how are these two provisional data analyses different from your office’s “preliminary data” released in the recent past?

LR:  The most recent Quarterly Provisional Estimates provide an update to some of the data released in the recent report, Births: Provisional Data for 2016. That report is similar to previous “preliminary birth data” reports, but is redesigned and released under our Vital Statistics Rapid Release (VSRR) program. We hope that the VSRR program can be a one-stop-shop for our provisional vital statistics data. The Quarterly Provisional Estimates describe very recent trends in key indicators of maternal and infant health from the birth and mortality data the report, Births: Provisional Data for 2016, provides some critical context for understanding these recent trends.  report also describes some additional demographic and reproductive health indicators that aren’t yet available in the Quarterly Provisional Estimates, such as birth rates by race and Hispanic origin, as well as the timing of prenatal care.


Q: What in your data analyses can be attributed to no change in infant mortality in the last few quarters?

LR: is another surprising and concerning finding, because infant mortality rates have generally been declining over the past decade, at least through 2014. These declines seem to have leveled off more recently, according to our provisional estimates. We can’t speak to why infant mortality rates might no longer be declining, but we are planning future research to help us better understand this troubling trend.    


Q: What differences did you see among various age groups of mothers?

LR: There is a great deal of detail in the recent report, Births: Provisional Data for 2016, discussing how age-specific birth rates have changed recently. Generally, both that report and our recent Quarterly Provisional Estimates show that maternal age is increasing. Birth rates among younger women (under 30) are going down, while those among women 35 and up are increasing.


Q: What are seasonal fluctuations in the number of infant deaths and births, and what do you mean by accounting for seasonality as you described in your report’s preface?

LR: People may not think that there are seasonal patterns to births, but it turns out that there are more babies born in the third quarter of the year, from July-September, than during other parts of the year. There are seasonal patterns in other indicators as well. For example, preterm birth rates dip slightly in the third quarter compared with other quarters, while infant mortality rates tend to be a bit higher in the beginning of the year than toward the end of the year. So to ensure that any differences we find aren’t influenced by seasonal fluctuations, we only compare the most recent quarter with the same quarter from the previous year. We also present 12 month-ending estimates, which include all seasons of the year, and thus aren’t subject to seasonal ups and downs.


Births: Provisional Data for 2016

June 30, 2017

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author on “Births: Provisional Data for 2016

Q: Why did you decide to change the name of the report from preliminary to provisional?

BH: report is part of the National Vital Statistics System, Vital Statistics Rapid Release provisional data series which replaces the preliminary report series to provide a consistent set of quarterly and annual data releases. Except for small changes in record weights, the same processing procedure was used for provisional as was used for the preliminary data and the data are comparable.


Q: How does provisional 2016 data on U.S. births overall compare to previous years?

BH: The provisional number of births for the United States was down 1% in 2016 from the final number of birth in 2015. The general fertility rate was down too from 2015, 1%, to 62.0 births per 1,000 women aged 15–44, a record low for the county.

Birth rates declined for women in all age groups under 30 years between 2015 and 2016, to record lows for all groups, whereas the rates for women in their 30s and 40s rose.

The nonmarital birth rate declined 3% in 2016. In 2016, slightly more than 3 out of 4 women began prenatal care in the first trimester, down 3% from 2015. The cesarean delivery rate declined in 2016 for the fourth year in a row (to 31.9%). However, the preterm birth rate rose for the second year in a row in 2016 (to 9.84%) and the low birthweight rate was also up for the second straight year in 2016 (to 8.16%).


Q: How has the birth rate changed for U.S. teenagers in provisional 2016 data?

BH: The birth rate for teenagers aged 15–19 declined 9% in 2016 to 20.3 births per 1,000 women, with rates declining 11% for both younger (aged 15–17) and 8% for older (aged 18–19) teenagers. The 9% decline for teenaged 15-19 from 2015 to 2016 is atop of a continuous average decline of 8% from 2007 through 2014.

(The rates for younger and older teens declined on average by 11% and 8% from 2007 through 2014.)


Q: Was there anything in the 2016 provisional birth data that surprised you?

BH: Apart from the continued, unprecedented decline in teen birth, it is worth noting that women aged 30-34 have the highest birth rate (102.6 births per 1,000 women) in 2016 than any other age group. Since 1983, the rate for women in their late thirties was the highest.

In addition, it is also worth noting the rise in the preterm birth rate which was up again in 2016 (by 2%), after falling 8% from 2007 to 2014.


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

BH: The number of births and general fertility rate were down in 2016, as were the rates for women under 30 years of age.  The percentage of births beginning prenatal care in the first trimester and the cesarean delivery rate were also down in 2016, whereas preterm birth and low birthweight rates rose.


Stat of the Day – June 26, 2017

June 26, 2017


Stat of the Day – May 18, 2017

May 18, 2017