QuickStats: Rate of Unintentional Traumatic Brain Injury (TBI)–Related Deaths Among Persons Aged 24 Years and Under, by Age Group

October 16, 2020

From 1999 to 2018, death rates for unintentional TBI among persons aged 24 years and under declined across all age groups.

During the 20-year period, TBI-related death rates declined from 3.7 per 100,000 to 1.5 among children aged 0–4 years, from 3.0 to 0.9 for children and adolescents aged 5–14 years, from 14.7 to 4.4 for adolescents and young adults aged 15–19 years, and from 14.1 to 6.9 for young adults aged 20–24 years.

For most of the period, rates were highest for persons aged 20–24 years followed by those aged 15–19, 0–4, and 5–14 years.

Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data. https://www.cdc.gov/nchs/deaths.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6941a5.htm


Fast Food Intake Among Children and Adolescents in the United States, 2015–2018

August 14, 2020

Questions for Cheryl Fryar, Health Statistician and Lead Author of “Fast Food Intake Among Children and Adolescents in the United States, 2015–2018.”

Q: Why does NCHS conduct studies on fast food consumption among children and adolescents?

CF: We focus on fast food for this report because fast food continues to play an important role in the American diet. Fast food has been associated with poor diet and increased risk of obesity. In a previous report, we described the percentage of calories consumed from fast food among children and adolescents during 201-2012. This report provides an update on the daily percentage of calories consumed from fast food by children and adolescents aged 2-19 years during 2015-2018 and trends since 2003.


Q: How did the data vary by age groups, sex and race?

CF: There were some demographic differences in the daily percentage of calories consumed from fast food. Adolescents aged 12–19 consumed a higher percentage of calories (16.7%) from fast food than younger children (11.4%) aged 2-11 years. Girls consumed a higher percentage than boys and non-Hispanic white adolescents consumed a lower percentage than the other race and Hispanic origin groups. This brief report did not examine confounders that may possibly explain demographic differences.


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

CF: While there really wasn’t anything in this report that I hadn’t expected to see or that was surprising to me, this report’s trends analysis is of interest. The daily percentage of calories from fast food in children and adolescents decreased from 14.1% in 2003–2004 to 10.6% in 2009–2010, and then increased to 14.4% in 2017-2018.


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

CF: The National Health and Nutrition Examination Survey (NHANES) is the source of the data.  Since 1999, NHANES has been conducted on a continuous basis, and visits approximately 15 counties each year of various population size.  The survey conducts at home health interviews and health examinations in mobile examination centers (MEC) with nearly 5000 people each year.   Information on nutrient intake was obtained from one 24-hour dietary recall interview administered in-person at the MEC.  Specifically, anyone who reported obtaining any food or beverage from “restaurant fast food/pizza” was someone who consumed fast food on a given day.  Dietary recalls cover intake for any given day, specifically the 24-hour period prior to the dietary recall interview (midnight to midnight).

For survey participants < 6 years of age a proxy was used (who was generally the person most knowledgeable about the child’s food intake). For children ages 6- 8, interviews were conducted with a proxy and with the child present to assist in reporting intake information. Interviews of children ages 9-11, were conducted with the child and the assistance of an adult familiar with the child’s intake. Adolescents 12 years or older answered for themselves.


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

CF: The take-home message for this report is that more than one-third (36.3%) of U.S. children and adolescents consume fast food on a given day. Overall, children and adolescents consume, on average, 13.8% of their daily calories from fast food.  And, on a given day, over 11% of children and adolescents consume more than 45% of their daily calories from fast food.

Diet and exercise play important roles in helping individuals achieve and maintain their health.  The USDA/HHS’ Dietary Guidelines for Americans 2015 provides guidance in healthy food choices.  In addition, HHS’ 2018 Physical Activity Guidelines for Americans provides guidance for all ages in improving health through physical activity.


QuickStats: Prevalence of Obesity and Severe Obesity Among Persons Aged 2–19 Years — National Health and Nutrition Examination Survey, 1999–2000 through 2017–2018

April 3, 2020

From 1999–2000 to 2017–2018, the prevalence of obesity among persons aged 2–19 years increased from 13.9% to 19.3%, and the prevalence of severe obesity increased from 3.6% to 6.1%.

Source: National Center for Health Statistics, National Health and Nutrition Examination Survey, 1999–2000 to 2017–2018. https://www.cdc.gov/nchs/nhanes.htm.


QuickStats: Percentage of Children and Adolescents Aged 4–17 Years with Serious Emotional or Behavioral Difficulties by Sex and Urbanization Level

March 13, 2020

During 2016–2018, the percentage of children and adolescents aged 4–17 years with serious emotional or behavioral difficulties was higher among those living in nonmetropolitan areas (6.7%) than among those living in metropolitan areas (5.3%).

Among boys, those living in nonmetropolitan areas (8.5%) were more likely to have serious emotional or behavioral difficulties than those living in metropolitan areas (6.6%), but the difference among girls was smaller and not significant.

Among children and adolescents living in either metropolitan or nonmetropolitan areas, boys were more likely than girls to have serious emotional or behavioral difficulties.

Source: National Health Interview Survey, 2016–2018. https://www.cdc.gov/nchs/nhis/index.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6910a6.htm


Racial and Ethnic Differences in the Prevalence of Attention-deficit/Hyperactivity Disorder and Learning Disabilities Among U.S. Children Aged 3–17 Years

March 4, 2020

Attention-deficit/hyperactivity disorder (ADHD) and learning disabilities are the most commonly diagnosed neurodevelopmental disorders in children and often coexist.

Previous research has suggested that the prevalence of these conditions may differ by race and Hispanic origin.

Using timely, nationally representative data, this report examines the reported prevalence of ADHD and learning disabilities by race and ethnicity and select demographic characteristics that are associated with the diagnosis of these conditions.

Findings: 

  • In 2016–2018, nearly 14% of children aged 3–17 years were reported as ever having been diagnosed with either attention-deficit/hyperactivity disorder (ADHD) or a learning disability; non-Hispanic black children were the most likely to be diagnosed (16.9%).
  • Among children aged 3–10 years, non-Hispanic black children were more likely to have ever been diagnosed with ADHD or a learning disability compared with non-Hispanic white or Hispanic children.
  • Diagnosis of ADHD or a learning disability differed by federal poverty level for children in all racial and ethnic groups.
  • Diagnosis of ADHD or a learning disability differed by parental education among non-Hispanic white children only.

Prevalence of Children Aged 3–17 Years With Developmental Disabilities, by Urbanicity: United States, 2015–2018

February 19, 2020

Questions for Ben Zablotsky, Ph.D., Health Statistician and Lead Author of “Prevalence of Children Aged 3–17 Years With Developmental Disabilities, by Urbanicity: United States, 2015–2018.”

Q: Why did you decide to focus on urbanicity among children with developmental disabilities?

BZ: Thanks to previous research, we know that children with developmental disabilities typically require more health care and educational services than their typically developing peers, and we also know that children living in rural areas have greater unmet medical needs when compared to children living in urban areas.  For these two reasons, it is possible, that children with developmental disabilities living in rural areas could represent some of the most vulnerable when it comes to receiving a variety of health care services.  This report attempts to answer this question, by exploring the prevalence of selected developmental disability conditions and use of related services in rural and urban areas.  It serves as a follow-up to a previous Pediatrics article written by myself and Lindsey Black, along with colleagues from the National Center for Health Statistics, National Center on Birth Defects and Developmental Disabilities, and the Maternal and Child Health Bureau, titled “Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017


Q: How did you obtain this data for this report and what is considered a developmental disability?

BZ: Data come from the 2015-2018 National Health Interview Survey, a timely and nationally representative survey.  Developmental disabilities examined in this report were attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures in the past 12 months, stuttering or stammering in the past 12 months, or any other developmental delay. Children whose parents answered that their child had one or more of these conditions were classified as having any “developmental disability.”


Q: Can you summarize how the data varied by types of developmental disabilities and service utilization in rural and urban areas?

BZ: During 2015-2018, children were more likely to be diagnosed with ADHD and cerebral palsy in rural areas than urban areas.  Meanwhile, children with developmental disabilities living in rural areas were less likely to have seen a mental health professional, therapist, or had a well-child check-up in the past 12 months than their urban peers.  Children with developmental disabilities in rural areas were also less likely to be receiving Special Education or Early Intervention Services.


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

BZ: Children with developmental disabilities often need specialty and mental health services.  It was surprising to see that approximately half of children with developmental disabilities living in rural areas had not seen a mental health professional, specialist, or therapist in the past year.


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

BZ: There was a higher prevalence of children with developmental disabilities in rural areas compared with urban areas. Furthermore, among children with developmental disabilities, those living in rural areas were less likely to use a range of health care and educational services compared with their urban peers.  Additional research exploring the pathways to the diagnosis and treatment of developmental disabilities in both urban and rural areas, with a focus on the availability of resources to pay for services as well as access to trained specialty providers, could provide insight into the disparities seen in this report.


Births: Final Data for 2018

November 27, 2019

Questions for Joyce Martin, Health Statistician and Lead Author of “Births: Final Data for 2018

Q: What is new in this report from the 2018 provisional birth report?

JM: In addition to providing final numbers and rates for numerous birth characteristics such as fertility rates, teen childbearing, cesarean delivery and preterm and low birthweight, this report presents final information on  teen childbearing by race and Hispanic origin and by state, births to unmarried women, tobacco use during pregnancy, source of payment for the delivery and twin and triplet childbearing.


Q: Was there a specific finding in the 2018 final birth data that surprised you?

JM: The continued decline in birth rates to unmarried women (down 2% for 2017-2018 to 40.1 births per 1,000 unmarried women), the fairly steep decline in tobacco smoking among pregnant women (down 6% to 6.5% of all women) and the continued declines in twin (down 2%) and triplet (down 8%) birth rates.  Also of note is the decline in the percentage of births covered by Medicaid between 2017 and 2018 (down 2% to 42.3%) and the small rise in the percentage covered by private insurance (49.6% in 2018).


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

JM: These data are based on information for all birth certificates registered in the United States for 2018.


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

JM: Birth certificate data provide a wealth of important current and trend information on demographic and maternal and infant health characteristics for the United States.


Q: Why do you think the birth has dropped in the U.S.?

JM: The factors associated with family formation and childbearing are numerous and complex, involving psychological, cultural, demographic, and socio-economic influences. The data on which the report is based come from all birth certificates registered in the U.S. While the data provide a wealth of information on topics such as the number of births occurring in small areas, to small population groups, and for rare health outcomes, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, the data in and of itself cannot answer the question of why births have dropped in the U.S.


Vision testing among children aged 3-5 years in the United States, 2016-2017

November 20, 2019

Questions for Lindsey Black, M.P.H., Health Statistician and Lead Author of “Vision testing among children aged 3-5 years in the United States, 2016-2017

Q: Why did you decide to focus on vision testing for children aged 3-5?

LB: Over a quarter of all children aged 0-17 years have vision problems (1). Two common eye problems, amblyopia (lazy eye) and strabismus (crossed eyes) can be treated and prevent further vision problems if they are found early (2). The USPSTF recommends children between 3-5 years old have vision screening (3) and Healthy People 2020 target for vision screening is 44.1% of preschool aged children (1). Despite this, little is known about the current prevalence of vision screening and how this may differ by population subgroups. We focused on children 3-5 years old as they are the focus of the USPSTF recommendations.

  1. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Accessed at : https://www.healthypeople.gov/2020/topics-objectives/topic/vision/objectives
  2. Office of Disease Prevention and Health Promotion. Get your child’s vision checked. Washington DC. Accessed at: https://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-your-childs-vision-checked
  3. US Preventive Services Task Force. Vision Screening for Children 1 to 5 Years of Age: US Preventive Services Task Force Recommendation Statement. Pediatrics 127, 2 p340

Q: How did the data vary by age, race and health insurance?

LB: Overall, as children aged, they were more likely to have ever had their vision tested. Additionally, as children aged, they were also more likely to have had their vision tested in the past 12 months. There was also variation by race and Hispanic origin. About 65% of Non-Hispanic white children, 63% of non-Hispanic black children and 59% of Hispanic children have ever had their vision tested. Children with private health insurance (66.7%) were most likely to have ever had their vision tested compared with children with public insurance (61.2%) and children who are uninsured (43.3%).


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

LB: It was surprising how much of an impact a recent well-child visit had on ever having a vision test. Children who did not receive a well-child visit in the past 12 months (44.1%) were less likely to have ever had their vision tested when compared to children that had received a well-child visit in the past 12 months (65.9%). Since vision screenings are recommended to be part of well-child visits, these visits provide valuable opportunities to detect problems and offer intervention efforts.


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

LB: Data are from the pooled 2016-2017 National Health Interview Survey and can be accessed via: https://www.cdc.gov/nchs/nhis.htm. Questions on vision testing are from supplement questions, which focused on expanded content related to child vision. This supplement was asked most recently in 2016-2017.


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

LB: Approximately 64% of children aged 3-5 have ever had their vision tested by a doctor or other health professional. As children age, they are more likely to have had their vision tested. Disparities exist by race, and health insurance status. Receipt of a recent well-child visit was also associated with a higher prevalence of receiving a vision test.

 


Emergency Department Visits for Injuries Sustained During Sports and Recreational Activities by Patients Aged 5–24 Years, 2010–2016

November 15, 2019

Questions for Lead Author Anna Rui, Health Statistician, of “Emergency Department Visits for Injuries Sustained During Sports and Recreational Activities by Patients Aged 5–24 Years, 2010–2016.”

Q: What do you think is the most significant finding in this report?

AR: The top activities that caused emergency room (ER) visits for sports injuries by patients ages 5-24 years were football, basketball, pedal cycling, and soccer. There was wide variation by age and sex in the types of activities causing ER visits for sports injuries.


Q: Out of all of the sports, which sport or activity was found to have the largest increase in ER visits over time?

AR: We did not assess trends over time in the report.


Q: Is it accurate to say that the sports in the study are the most dangerous? Or do they have the most ER visits because they are simply the most popular?

AR: There are likely other health care utilization measures besides ER visits that others would want to look at as well, but the purpose of the report was to estimate the number of ER visits for sports injuries, and these are the sports that account for the most visits.


Q: What are some limitations of the report?

AR: The definition of sports and recreational activities relied on data processing and manual review of medical records, which could have resulted in over- or under-estimation of the sports injury ER rate. The study did not include patients who sought care in other settings or who did not seek care; thus the estimates in the report are an underestimate of all health care utilization for sports injuries.


Q: Why is this report important?

AR: Many young Americans engage in some type of sports or recreational activity each year, and sports and recreation-related injuries are a common type of injury seen in hospital ERs. It’s important to understand the types of injuries that are most commonly seen in the ER and which sports account for those injuries in order to monitor and guide injury prevention efforts. In addition, we provide updated estimates of treatments administered in the ER for sports injuries, which provides new information that can be used to monitor improvements to the quality and value of care and serve as a benchmark for future studies.


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.