Prevalence and Trends of Developmental Disabilities Among U.S. Children

September 26, 2019

A new study from Pediatrics shows looks the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using National Health Interview Survey data.

The study found that from 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%–17.8%), attention-deficit/hyperactivity disorder (8.5%–9.5%), autism spectrum disorder (1.1%–2.5%), and intellectual disability (0.9%–1.2%), but a significant decrease for any other developmental delay (4.7%–4.1%).

The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight less than 2500 g, and children living in urban areas and with less-educated mothers.

For more information, please click on the link


Characteristics of Asthma Visits to Physician Offices in the United States: 2012–2015 National Ambulatory Medical Care Survey

September 20, 2019

Questions for Lead Author Lara Akinbami, Health Statistician, of “Characteristics of Asthma Visits to Physician Offices in the United States: 2012–2015 National Ambulatory Medical Care Survey.”

Q: Why did you decide to do a report on asthma visits to physician offices?

LK: Asthma is a common chronic condition in the United States: in 2016 8.3% of the population had asthma.  Each year, there are nearly 2 million emergency department visits, over 300,000 hospitalizations and more than 3.500 deaths in the United States due to asthma.

These adverse outcomes arise when episodic asthma attacks become severe.  A key part of preventing these adverse asthma outcomes is the prevention of attacks, and early recognition and management of symptoms.  Physicians in non-emergent community settings have a key role in partnering with people with asthma in identifying and monitoring symptoms, and developing a plan to avoid things that trigger attacks, and providing a medication plan to reduce symptoms when they do arise.  There are evidence-based national asthma guidelines that provide recommendations on how to best manage asthma that are directed toward care in physician offices (https://www.ncbi.nlm.nih.gov/books/NBK7232/).  Furthermore, asthma is now increasingly recognized as a risk factor for chronic obstructive pulmonary disease, the fourth leading cause of death in the US, and diagnosis and management of asthma is as an important part of monitoring lung health through the lifespan.

For all these reasons, assessing trends in visits to physician offices is useful in tracking the characteristics of asthma patients, the reasons asthma patients seek care (routine monitoring or acute care), and the services provided in these visits.  These help answer questions that can direct interventions, for example, “Are certain groups less likely to seek care in office settings?” Or “Are guideline recommendations being followed?”


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

LK: Asthma visit rates tend to reflect the prevalence of asthma in the population, but with some notable exceptions.  Asthma prevalence is higher in children than in adults, and children have higher asthma physician office visit rates than adults.  However, although asthma prevalence peaks in mid-childhood, we see high rates of asthma visits among children 0-4 years of age.  This is because these very young children have smaller airways.  They are more likely to show symptoms with any conditions that further narrows the airways, such as respiratory infections.

Another interesting pattern is that asthma prevalence is higher among boys than girls, in contrast to among adults in whom women have higher asthma prevalence than men.  Asthma visit rates also reflect this pattern with boys having higher visit rates than girls, and women having higher visit rates than men.  However, once the differences in prevalence are accounted for by looking at just people who have asthma, boys with asthma have similar asthma visit rates as girls with asthma, and the same is true for men and women with asthma.  The one exception is that very young boys ages 0-4 yeas with asthma still have higher rates of asthma visits than 0-4 year old girls with asthma.

By race and Hispanic origin, asthma visit rates are similar between groups with no differences seen between asthma visits rates for non-Hispanic white, non-Hispanic black and Hispanic persons.  Asthma visit rates were lower for persons of non-Hispanic other race.  However, this pattern does not reflect asthma prevalence which is higher for non-Hispanic black persons than non-Hispanic white and Hispanic persons.


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

LK: The Centers for Disease Control and Prevention publishes regular asthma surveillance reports on asthma that provide analysis of trends and estimates of the most recent data for asthma prevalence, health care utilization and death.  The CDC also provides a web page with the most recent asthma data: https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm.  However, this report is only the second since 1996 to analyze asthma visits to physician offices in depth, including the degree to which services in asthma visits reflect recommendations in the national asthma guidelines.  These guidelines were originally released in 1991 with the most recent update in 2007.  When findings of this report which analyzed data from 2012-2015 is compared to the 1996 report that analyzed data from 1993-1994, we found that despite an increase in asthma prevalence over this period, the annual average number of asthma visits declined from 11 million in 1993-1994 to 10.2 million in 2012-2015.  Medications in 2012-2015 included newer medications that target airway inflammation.  A similar percentage of asthma visits were seen by primary care physicians as opposed to asthma specialists, 65% in 1993-1994 and 60% in 2012-2015.  However, there was less progress in increasing the implementation of national asthma guidelines than would be expected given the effort to increase uptake of key recommendations such as providing an asthma action plan and documenting asthma severity and control.


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

LK: Given the emphasis on the importance of assessing and documenting asthma control, only 40.9% of asthma visits to physician offices had a level of asthma control documented.  The distribution between levels of asthma control was expected with 29.1% of patients with well controlled asthma, 10.5% with not well controlled asthma and 1.3% of patients with very poorly controlled asthma.  However, that 59.1% of asthma patients had no level of control documented was surprising given the concerted efforts to have asthma control assessed and documented.  These efforts included quality of care measurements, physician continuing education, a Guideline Implementation Report (https://www.nhlbi.nih.gov/files/docs/guidelines/gip_rpt.pdf), and local quality improvement projects.


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

LK: Asthma is a common chronic condition and a common reason for physician office visits.  Given its high burden in morbidity, health care use, and mortality, it is important to assess the content of asthma physician office visits given that physicians are the on the “front line” of asthma care and provide the majority of asthma care.  Rates for asthma visits to physician offices started to decline before total office visit rates declined.  Asthma education, objective monitoring (pulmonary function  testing) and level of asthma control were documented in a minority of visits.  Quick-acting relief medication remained the most frequently mentioned medication class.  Additional research can explore the underlying reasons for trends, and future policy can target low implementation rates of guideline recommendations.


Births: Provisional Data for 2018

May 15, 2019

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2018.”

Q: How does the provisional 2018 birth data compare to previous years?

BH: The  number of births, the general fertility rate, the total fertility rate, birth rates for women aged 15-34, the cesarean delivery rate and the low-risk cesarean delivery rate declined from 2017 to 2018, whereas the birth rates for women aged 35-44 and the preterm birth rate rose.


Q: When do you expect the final 2018 birth report to come out?

BH: The 2018 final birth report is scheduled for release in the fall of 2019.


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

BH:  Birth measures shown in the report varied widely by age and race and Hispanic origin groups. Birth rates ranged from 0.2 births per 1,000 females aged 10-14 to 99.6 births per 1,000 women aged 30-34. By race and Hispanic origin, the cesarean delivery rate ranged from 28.7% of births for non-Hispanic American Indian or Alaska Native women to 36.1% for non-Hispanic black women and the preterm birth rate ranged from 8.56% for non-Hispanic Asian women to 14.12% for non-Hispanic black women.


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

BH: The report includes a number of interesting findings. The record lows reached for the general fertility rate, the total fertility rate and birth rates for females aged 15-19, 15-17, 18-19, and 20-24 are noteworthy. In addition, the magnitude of the continued decline in the birth rate for teens aged 15-19, down 7% from 2017 to 2018, is also historic.


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

BH:  The number of births for the United States was down 2% from 2017 to 2018, as were the general fertility rate and the total fertility rate, with both at record lows in 2018. Birth rates declined for nearly all age groups of women under 35, but rose for women in their late 30s and early 40s. The birth rate for teenagers aged 15–19 was down 7% from 2017 to 2018. The cesarean delivery rate and low-risk cesarean delivery rate were down in 2018. The preterm birth rate rose for the fourth year in a row in 2018.


Q: Do you anticipate this drop will continue?

BH: The factors associated with family formation and childbearing are numerous and complex. The data on which the report are based come from all birth certificates registered in the U.S. While the scope of these data is wide, with detailed demographic and health   information on rare events, small areas, or small population groups, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, these data do not answer the question of why the number of births dropped in 2018 or if the decline will continue.


Fact or Fiction: Is yoga is the fastest-growing complementary health approach among children and adults in the United States?

November 8, 2018

 


Use Of Yoga and Meditation Becoming More Popular in U.S.

November 8, 2018

The use of yoga and meditation has increased in the U.S., according to two new reports released by the CDC’s National Center for Health Statistics (NCHS).

The first report “Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18 and Older” examines changes from 2012 to 2017 in the percentage of U.S. adults that used yoga, meditation and chiropractors in the past 12 months. Of the three complementary health approached presented, yoga was the most commonly among U.S. adults in 2012 (9.5%) and 2017 (14.3%). The use of meditation increased more than threefold from 4.1% in 2012 to 14.2% in 2017.

The second report released today, “Use of Yoga, Meditation and Chiropractors Among U.S. Children Aged 4–17 Years,” reveals that U.S. children aged 4-17 years who used yoga in the past 12 months increased significantly from 3.1% in 2012 to 8.4% in 2017. Further examination of 2017 data showed that girls were more likely than boys to have used yoga in the past 12 months (11.3% vs. 5.6%).

Other findings documented in the reports:

  • In 2017, the use of yoga among U.S. adults aged 18-44 (17.9%) was more than twice that of adults 65 years and older (6.7%).
  • In 2017, non-Hispanic white adults were more likely to use yoga (17.1%) and see a chiropractor (12.7%) in the past 12 months compared with Hispanic (8% and 6.6%, respectively) and non-Hispanic black (9.3% and 5.5%, respectively) adults.
  • The use of yoga, meditation and chiropractors saw a significant increase from 2012 to 2017, among U.S. adults.
  • Use of meditation increased significantly for U.S. children from 0.6% in 2012 to 5.4% in 2017.
  • Older U.S. children aged 12-17 were more likely to have used meditation (6.5%) and a chiropractor (5.1%) than younger children aged 4-11 (4.7% and 2.1% respectively) in 2017.
  • There was no significant difference in the use of a chiropractor for children from 2012 to 2017.

The two reports, “Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18 and Older” and “Use of Yoga, Meditation and Chiropractors Among U.S. Children Aged 4–17 Years” are available on the NCHS web site at www.cdc.gov/nchs.


QuickStats: Percentage of Youths Aged 2–19 Years Consuming Any Fast Food on a Given Day, by Race and Hispanic Origin — National Health and Nutrition Examination Survey, 2013–2016

October 15, 2018

During 2013–2016, 36.0% of youths aged 2–19 consumed fast food on a given day.

Non-Hispanic Asian youths (27.3%) had a lower percentage of fast food consumption on a given day, compared with non-Hispanic black (39.6%), Hispanic (36.6%), and non-Hispanic white (35.4%) youths.

There were no significant differences in fast food consumption on a given day among non-Hispanic white, non-Hispanic black, and Hispanic youths.

Source: National Center for Health Statistics Data Brief No. 322. https://www.cdc.gov/nchs/products/databriefs/db322.htm; National Center for Health Statistics, National Health and Nutrition Examination Survey Data, 2013–2016. https://www.cdc.gov/nchs/nhanes.htm.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6740a8.htm


Fact or Fiction: Do soft drinks account for one-fifth of all beverages consumed by American youth between ages 2 and 19?

September 13, 2018

Sources : National Health and Nutrition Survey, 2013-2016

https://www.cdc.gov/nchs/data/databriefs/db320.pdf


Beverage Consumption Among Youth in the United States, 2013-2016

September 13, 2018

Kirsten A. Herrick, Ph.D., M.Sc, NCHS Epidemiologist

Questions for Kirsten A. Herrick, Ph.D., M.Sc, Epidemiologist and Lead Author of “Beverage Consumption Among Youth in the United States, 2013-2016

Q: What made you decide to focus on what children in the United States drink for this study?

KH: In a previous report, we described the consumption of sugar-sweetened beverages among youth. This current study looks at beverage consumption in a different way. We are looking at all types of beverages, rather than focusing on only those that contain sugar or calories (energy.) Specifically in this new report, we look at beverage types by amount (grams) rather than by calories.


Q: Was there a finding in your new report that you hadn’t expected and that really surprised you?

KH: While there was nothing in this report that I hadn’t expected to see or that was surprising to me, the data results in this analysis do offer some new perspective. A new contribution from this research is a look at beverage consumption among non-Hispanic Asian youth and how this compares to other race and Hispanic origin groups. A notable finding is that non-Hispanic Asian youth drink more water compared to other groups.


Q: What differences or similarities did you see between or among various demographic groups in this analysis?

KH: We observed quite a few variations among demographic groups in our analysis of what youth in the United States are drinking. One interesting observation was that the contribution of milk and 100% juice to all beverage consumption, decreased with age—while the contribution of water and soft-drinks increased with age. While the types of beverages boys and girls drink are similar, we found that for Asian youth water accounted for the largest share of all beverages consumed compared with other race groups. The amount of beverages consumed as soft drinks was largest for non-Hispanic Black youth compared with other race groups, and the contribution of milk to overall beverage consumption is lowest among non-Hispanic Black youth in America.


Q: What would you say is the take-home message of this report?

KH: I think the real take-home message of this report is that beverage consumption is not the same for all U.S. youth. Since beverages contribute to hydration, energy and vitamin and mineral intake, these choices can impact diet quality and total caloric intake. It is very valuable for the U.S. Public Health Community to have this information, which can help guide their important work throughout America. I think it’s valuable information for families to have as well—and for youth in the U.S. to also be aware of the potential impact of these choices.


Q: What type of trend data do you have for U.S. children’s beverage consumption, and how has it changed over time, for example the last 20 years?

KH: While this report did not look at trends, the reason it does not present trends can tell us a lot about beverage consumption analysis over the years. The types of beverages available today are different than 20 years ago or in other years past. So trends wouldn’t strictly be comparing the same things over time.

Plus, this new report isn’t directly comparable with previous reports. For example, in this new Data Brief we looked at soft drinks and defined them as diet and non-diet forms of soda and fruit drinks. So this soft drink category is not equivalent to sugar-sweetened beverages—which has been the focus of some of our earlier analyses. Also, many past reports where we might have looked for trends—were interested in the energy from beverages. But water, an important beverage for hydration, doesn’t have calories, and therefore is often left out of earlier discussions and analyses about beverage consumption. In our new report we looked at total beverage consumption by amount (in grams) so we could include ALL beverages, not just those that contribute to calorie consumption.


Recent Increases in Injury Mortality Among Children and Adolescents Aged 10–19 Years in the United States: 1999–2016

June 4, 2018

NCHS released a new report that presents numbers of injury deaths and death rates for children and adolescents aged 10–19 years in the United States for 1999–2016.

Numbers and rates are presented by sex for 1999–2016, by injury intent (e.g., unintentional, suicide, and homicide) and method (e.g., motor vehicle traffic, firearms, and suffocation). Numbers and rates of death according to leading injury intents and methods are shown by sex for ages 10–14 years and 15–19 years for 2016.

Findings:

  • The total death rate for persons aged 10–19 years declined 33% between 1999 (44.4 per 100,000 population) and 2013 (29.6) and then increased 12% between 2013 and 2016 (33.1).
  • This recent rise is attributable to an increase in injury deaths for persons aged 10–19 years during 2013–2016.
  • Increases occurred among all three leading injury intents (unintentional, suicide, and homicide) during 2013–2016.
  • Unintentional injury, the leading injury intent for children and adolescents aged 10–19 years in 2016, declined 49% between 1999 (20.6) and 2013 (10.6), and then increased 13% between 2013 and 2016 (12.0).
  • The death rate for suicide, the second leading injury intent among ages 10–19 years in 2016, declined 15% between 1999 and 2007 (from 4.6 to 3.9), and then increased 56% between 2007 and 2016 (6.1).
  • The death rate for homicide, the third leading intent of injury death in 2016, fluctuated and then declined 35% between 2007 (5.7) and 2014 (3.7) before increasing 27%, to 4.7 in 2016.

Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2017

May 22, 2018

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2017

Q: What were some of the major findings in your full-year 2017 health insurance estimates?

RC: In 2017, 29.3 million persons were uninsured at the time of interview. This is 19.3 million fewer persons than in 2010. In 2017, 9.1% were uninsured, 36.2% had public coverage, and 62.6% had private coverage at the time of interview.


Q: What are the trends among race and ethnicity groups who were uninsured in 2017 and compared over time?

RC: In 2017, 27.2% of Hispanic, 14.1% of non-Hispanic black, 8.5% of non-Hispanic white, and 7.6% of non-Hispanic Asian adults aged 18–64 lacked health insurance coverage at the time of interview.

Significant decreases in the percentage of uninsured adults were observed from 2013 through 2017 for Hispanic, non-Hispanic black, non-Hispanic white, and non-Hispanic Asian adults.

Hispanic adults had the greatest percentage point decrease in the uninsured rate from 2013 (40.6%) through 2016 (25.0%). The observed increase among Hispanic adults between 2016 and 2017 (27.2%) was not significant.


Q: What does your data show this year for Americans who have high-deductible health insurance plans compared to previous years?

RC: In 2017, 43.7% of persons under age 65 with private coverage were enrolled in a high-deductible health plan (HDHP). Enrollment in HDHPs has increased 18.4 percentage points from 25.3% in 2010 to 43.7% in 2017. More recently, the percentage enrolled in an HDHP increased from 39.4% in 2016 to 43.7% in 2017.


Q: What do you see in state-level estimates of health insurance coverage this year?

RC: Among the 18 states presented in this report, there were no significant changes in the percentages of uninsured among persons aged 18–64 between 2016 and 2017.


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

RC: The take-home message from this report is found in the number of Americans who no longer lack health insurance. In 2017, 29.3 million (9.1%) persons of all ages were uninsured at the time of interview. This estimate is not significantly different from 2016, but there are 19.3 million fewer uninsured persons than in 2010.