Parental Report of Significant Head Injuries in Children Aged 3–17 Years: United States, 2016

February 9, 2018

Questions for Lindsey Black, Health Statistician and Lead Author of “Parental Report of Significant Head Injuries in Children Aged 3–17 Years: United States, 2016.”

Q: What was the reason you undertook this research?

LB: Previous research has indicated that the incidence is increasing and much of this trend is being driven by an increase among adolescents. Current incidence of concussions among children is estimated to be 3.5-16.5/1,000. Despite what is known, studies conducted thus far regarding the epidemiology of childhood concussions have either been regional and limited in size, focused on injuries related to sports, dependent on insurance claims, or based on emergency department visits.

There is a lack of a national prevalence and we need to understand the problem outside of the scope of sports injuries. Depending on ED visits are also problematic because evidence is emerging that there is an increasing trend in the use of primary care physicians and specialty clinics as the point of entry into the healthcare system for concussion diagnosis and treatment. Also relying on ED or medical claims will not include non-medically attended concussions.

Further, much research focuses on high school and collegiate athletes and therefore there is not much data on younger children. Despite this, there has been recent recognition for concern and appropriate treatment by the medical community. The goal of this study was to provide a national estimate of parent-reported significant head injuries as well as examine disparities by various demographics and socioeconomic indicators.

Q: What did you find most significant?

LB: There was a steady increase in the percentage of children that had ever had a significant head injury by age group. Although overall boys were more likely than boys to have ever had a significant head injury, the difference was only significant for the 15-17 age group.

Q: Are there any data that look at what sports might be contributing to the number of significant head injuries among children?

LB: Yes, in fact there are many studies that focus on sport related injuries. Our survey and study did not. What sets our study apart is that it was not limited to sports related injuries, so it is going to include a wider range of causes of injuries. Please see “Emergency Department Visits for Concussion in Young Child Athletes” (Bakhos, 2010) and “Epidemiology of Concussion and Mild Traumatic Brain Injury” (Laker 2011) to learn more.

Q: Do you have any insight about whether this percentage who’ve had significant head injuries has increased or declined over time?

LB: Unfortunately we do not have any other historical data on this topic from our survey. At this time, these questions were asked only in 2016 as part of content sponsored by the National Instutite of Health’s National Institute on Deafness and Other Communication Disorders.

Q: Any other points you’d like to make about this study?

LB: We found that about 1 in 10 children in the oldest age group 15-17 had ever had a significant head injury. We also found that overall, boys were more likely than girls to have ever had a significant head injury and there were also disparities by race and parental educational attainment.

Estimated Prevalence of Children With Diagnosed Developmental Disabilities in the United States, 2014–2016

November 29, 2017

Questions for Ben Zablotsky, Ph.D., Health Statistician and Lead Author of “Estimated Prevalence of Children with Diagnosed Developmental Disabilities in the United States, 2014-2016.”

Q: Why did you decide to analyze children with diagnosed developmental disabilities?

BZ: We decided to analyze children with diagnosed developmental disability because children diagnosed with developmental disabilities typically require a substantial number of services and treatment to address both behavioral and developmental challenges.  Measuring the prevalence of children with these conditions aids in assessing the adequacy of available services and interventions that may improve long-term outcomes.

Q: Can you explain the differences between the diagnosed developmental disabilities studied in this report?

BZ: The three conditions studied in this report included autism spectrum disorder, intellectual disability, and any other developmental delay.  All three conditions are considered to be developmental disabilities.  Autism spectrum disorder refers to a group of neurodevelopmental disorders characterized by impairments in social communication and the presence of repetitive or restricted interests.  Intellectual disability is a term used when there are limits to a child’s ability to learn at an expected level and function in daily life.  Other developmental delay serves as a catch-all for children who are delayed for various developmental milestones, for example taking first steps, smiling for the first time, and speaking.

Q: What do you think is the most interesting demographic finding among your new study’s findings?

BZ: I found the fact that the prevalence of any developmental disability was lowest among Hispanic children compared with all other race and ethnicity groups to be the most interesting finding.  The prevalence of any developmental disability among Hispanic children was 4.69% compared to 7.04% for non-Hispanic white children, 6.20% for non-Hispanic black children, and 6.16% for non-Hispanic other children.

Q: Are there any previous reports released from NCHS on diagnosed developmental disabilities in children?

BZ: Yes, this report can be viewed as a follow-up to a National Health Statistics Report (No. 87) from 2015, where the prevalence of any developmental disability in 2014 was also reported (5.76%).  The current report shows this prevalence subsequently increased to 6.99% in 2016.

Q: Can you explain the methodology used for this analysis?

BZ: Children with developmental disabilities were identified through a series of survey questions within the child component of the National Health Interview Survey (NHIS) from 2014 to 2016.  Characteristics of these children were examined, including whether differences exist in prevalence by survey year.

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

BZ: There was a notable increase in the prevalence of developmental disabilities between 2014-2016, which is largely the result of an increase in the prevalence of children diagnosed with developmental delay other than autism spectrum disorder or intellectual disability.

QuickStats: Percentage of Children and Teens Aged 5–17 Years Who Missed >10 School Days in the Past 12 Months Because of Illness or Injury, by Sex and Age — National Health Interview Survey, 2013–2015

July 7, 2017


During 2013–2015, 3.9% of boys and 4.3% of girls missed >10 school days in the past 12 months because of illness or injury.

Among children aged 15–17 years, girls were more likely than boys to miss >10 school days (6.8% compared with 3.9%).

Among girls, those aged 15–17 years were more likely than girls aged 5–10 years and girls aged 11–14 years to miss >10 school days (6.8% compared with 3.2% and 4.0%, respectively).

Among boys, there was no difference by age.


QuickStats: Percentage of Children and Teens Aged 4–17 Years Ever Diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), by Sex and Urbanization of County of Residence

June 19, 2017


During 2013−2015, the percentage of children and teens aged 4–17 years who had ever received a diagnosis of ADHD was significantly higher among boys than among girls within all urbanization levels.

Among boys, those living in small metro and nonmetro micropolitan areas were more likely to have received a diagnosis of ADHD (17.4% and 16.4%, respectively) than were those living in large central (11.4%) and large fringe (12.7%) metropolitan areas.

Among girls, those living in large central areas were less likely to have received a diagnosis of ADHD (4.4%) than those living in each of the other five types of urban/rural areas.


QUICKSTATS: Brain Cancer Death Rates Among Children and Teens Aged 1–19 Years by Sex and Age Group — United States, 2013–2015

May 8, 2017

The death rate for brain cancer, the most common cancer cause of death for children and teens aged 1–19 years, was 24% higher in males (0.73 per 100,000) than females (0.59) aged 1–19 years during 2013–2015.

Death rates were higher for males than females for all age groups, but the difference did not reach statistical significance for the age group 5–9 years.

Death rates caused by brain cancer were highest at ages 5–9 years (0.98 for males and 0.85 for females).


State by State Health Data Source Updated on NCHS Web Site

April 19, 2017

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:

FACT OR FICTION: Do most boys and girls drink sugar-sweetened beverages each day?

January 26, 2017

Source: National Health and Nutrition Examination Survey

Sugar-Sweetened Beverage Consumption in U.S.

January 26, 2017
Asher Rosinger, Epidemic Intelligence Service Officer

Asher Rosinger, Epidemic Intelligence Service Officer

Questions for Asher Rosinger, Epidemic Intelligence Service Officer and Lead Author of “Sugar-Sweetened Beverage Consumption Among U.S. Adults, 2011–2014” and “Sugar-Sweetened Beverage Consumption Among U.S. Youth, 2011–2014

Q: Why did you decide to do a report on sugar-sweetened beverage consumption?

AR: Sugar-sweetened beverage consumption has been linked to a myriad of negative health conditions, such as weight gain, dental caries, and type 2 diabetes.

In these reports we wanted to provide the most recent estimates of the calories adults and youth are consuming from sugar-sweetened beverages, what percentage of their daily caloric intake sugar-sweetened beverages represented, and how these patterns differed by sex, age, and race and Hispanic origin.

Q: How do you define a sugar-sweetened beverage?

AR: We defined sugar-sweetened beverages to include regular soda, fruit drinks (including sweetened bottled waters and fruit juices and nectars with added sugars), sports and energy drinks, sweetened coffees and teas, and other pre-sweetened beverages. Sugar-sweetened beverages do not include diet drinks, defined as less than 40 kilocalories (kcal) per 240 mL of the beverage; 100% fruit juice; beverages sweetened by the participant, including coffee and teas; alcohol; or flavored milks. This definition is consistent with previous reports.

Q: Is this the first time NHANES has released a report on this topic? If not, where is trend data available?

AR: NHANES has reported on sugar-sweetened beverage consumption in a previous report and most recently in a journal article in the American Journal of Clinical Nutrition by Kit et al, which specifically looked at trends from 1999–2010 among youth and adults. We used the same definition as Kit et al. so that our results are comparable. The mean calorie consumption and percentage of total daily calories consumed from sugar-sweetened beverages among U.S. adults declined from 196 kcal and 8.7% in 1999–2000 to 151 kcal and 6.9% per day in 2009–2010. For youth the drop has been more dramatic. The mean calorie consumption and the percentage of calories consumed from sugar-sweetened beverages among U.S. youth declined from 223 kcal and 10.9% in 1999–2000 to 155 kcal and 8.0% per day in 2009–2010. Our reports found that in 2011–2014 U.S. adults consumed 145 kcal and 6.5% of their daily caloric intake from sugar-sweetened beverages, while U.S. youth consumed 143 kcal and 7.3%.

Kit BK, Fakhouri TH, Park S, Nielsen SJ, Ogden CL. Trends in sugar-sweetened beverage consumption among youth and adults in the United States: 1999–2010. Am J Clin Nutr 98(1):180–8. 2013.

Q: How many U.S. adults and children are consuming at least one sugar-sweetened beverage a day?

AR: Nearly half or 49.3% of U.S. adults and almost two-thirds or 62.9% of children are consuming at least one sugar-sweetened beverage a day. Using the 2011-2012 and 2013-2014 Alternative Population Control totals these percentages translate to more than 111 million U.S. adults and 47 million children who drank at least one sugar-sweetened beverage on a given day.

Q: Were there any findings that surprised you?

AR: We were surprised by the finding that non-Hispanic Asian adults and youth consumed fewer calories from sugar-sweetened beverages than any other race and Hispanic origin group. In fact, consumption in this group was nearly half the amount of calories and percent of total daily caloric intake than the other groups. For example, on average non-Hispanic Asian boys consumed 73 kilocalories from sugar-sweetened beverages representing 3.5% of their total daily caloric intake, whereas every other group consumed more than 150 kcals and more than 7% of their total caloric intake from sugar-sweetened beverages.

Physician Office Visits for ADHD in Children and Adolescents Aged 4–17 Years: United States, 2012–2013

January 25, 2017

Questions for Michael Albert, Medical Officer and Lead Author on “Physician Office Visits for Attention-deficit/Hyperactivity Disorder in Children and Adolescents Aged 4–17 Years: United States, 2012–2013

Q: Did we learn anything new from this new report about the problem of Attention-deficit/Hyperactivity Disorder (ADHD) among children?

MA: Yes, this report provides a snapshot of health care utilization related to ADHD among children aged 4-17 years. Specifically, it looks at visits to physician offices and uses nationally representative data from the 2012-13 National Ambulatory Medical Care Survey.  Based on a sample of 946 visits by children aged 4-17 years with a primary diagnosis of ADHD, an estimated annual average of 6.1 million physician office visits were made by this age group during 2012-13, corresponding to a visit rate of 105 visits per 1,000 children.

Q:  Does your research back up the notion that boys are more commonly afflicted with ADHD than girls?

MA: Our analysis did find that among children aged 4-17 years with a primary diagnosis of ADHD, the visit rate was more than twice as high for boys as girls.

Q: Is it true that medication is very often involved in the treatment of ADHD?

MA: Central nervous system stimulant medications were provided, prescribed, or continued at approximately 80% of these ADHD visits.  A total of 29% of ADHD visits included a diagnostic code for an additional mental health disorder.  In terms of what specialty of physician provided care at these visits, it was a pediatrician at 48%, psychiatrist at 36%, and general and family medicine physician at 12%.

Q: Was it surprising that 80% of office visits for ADHD involve medication?

MA: It is important to interpret this finding carefully.  Because the National Ambulatory Medical Care Survey is a visit-based survey, as opposed to population based, estimates of persons cannot be made.  Thus, the finding should not be interpreted as indicating that 80% of children aged 4-17 years with ADHD are taking CNS stimulant medications. It is possible that patients taking CNS stimulant medications tend to make more physician office visits than those not taking these medications.  This might be in order to monitor the medication, or for other reasons such as differences in the severity of disease between those who take medication and those who do not.  Although the use of medication in children with ADHD in our survey cannot be directly compared with population-based surveys, there is evidence from the latter that medication is frequently used.  An analysis of parent-reported data from the National Survey of Children’s Health found that among children aged 4-17 years, 69% of children with current ADHD were taking medication for their ADHD (the specific medication was not identified).

Q: Anything else you’d like to address about the report?

MA: Again, we think the significance of this report lies in providing a snapshot of health care utilization related to ADHD in children that is nationally representative.  We chose to investigate several variables to in our analysis that are of interest and provide important information.

QuickStats: Prevalence of Untreated Dental Caries in Permanent Teeth Among Children and Adolescents Aged 6–19 Years, by Age Group

January 17, 2017


During 2011–2014, 13.3% of children and adolescents aged 6–19 years had untreated dental caries in their permanent teeth.

The percentage of children and adolescents with untreated dental caries increased with age: 6.1% among those aged 6–11 years, 14.5% among those aged 12–15 years, and 22.6% among those aged 16–19 years.