Urgent Care Center and Retail Health Clinic Utilization Among Children: United States, 2019

December 3, 2020

Questions for Lindsey Black, Health Statistician and Lead Author of “Urgent Care Center and Retail Health Clinic Utilization Among Children: United States, 2019.”


Q: Why did you decide to research urgent care center and retail health clinic utilization among children? 

LB: This is a growing segment of health care delivery system where many American’s seek both preventative and acute care. In addition, 2019 was the first time that utilization of urgent care was assessed among respondents of the National Health Interview Survey.


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

LB: I was surprised there was not a linear relationship between age and utilization. Often, we see as age increases, service utilization decreases, and other work specific to urgent care utilization has found that adolescents and young adults are more likely to utilize urgent care and retail-based clinic care compared to children.


Q: Can you explain what retail health clinic utilization is?

LB: Urgent care and retail health clinics are facilities that provide health care services to patients and you do not need to make an appointment ahead of time. They can be free standing, or within a grocery store or retail store setting. Services provided often range from routine vaccination to non-emergency acute care.


Q: Is there any trend data for this report?

LB: No. This is the only year of data available that includes urgent care and retail health clinic utilization measures.


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

LB: More than 1 in 4 U.S. children (26.4%) have had one or more visits to an urgent care center or retail health clinic in past year according to 2019 data from the National Health Interview Survey.


Increases in Prepregnancy Obesity: United States, 2016–2019

November 25, 2020

A new NCHS report presents trends in prepregnancy obesity for 2016 through 2019 by maternal race and Hispanic origin, age, and educational attainment. Trends by state for 2016–2019 and 2019 rates also are shown.

Key Findings:

  • Prepregnancy obesity in the United States rose from 26.1% in 2016 to 29.0% in 2019 and increased steadily for non-Hispanic white, non-Hispanic black, and Hispanic women.
  • From 2016 through 2019, prepregnancy obesity increased among women of all ages and was lowest for women under age 20 (20.5% in 2019).
  • From 2016 through 2019, women with less than a bachelor’s degree were more likely to have prepregnancy obesity than those with a bachelor’s degree or higher, but obesity increased over time among all education levels.
  • Compared with 2016, prepregnancy obesity rose in every state but Vermont in 2019.

Chronic Pain and High-impact Chronic Pain Among U.S. Adults, 2019

November 4, 2020

Chronic pain and chronic pain that frequently limits life or work activities, referred to in this report as high-impact chronic pain, are among the most common reasons adults seek medical care and are associated with decreased quality of life, opioid dependence, and poor mental health. This report examines chronic pain and high-impact chronic pain in the past 3 months among U.S. adults aged 18 and over by selected demographic characteristics and urbanization level.

Key Findings:

  • In 2019, 20.4% of adults had chronic pain and 7.4% of adults had chronic pain that frequently limited life or work activities (referred to as high impact chronic pain) in the past 3 months.
  • Chronic pain and highimpact chronic pain both increased with age and were highest among adults aged 65 and over.
  • Non-Hispanic white adults (23.6%) were more likely to have chronic pain compared with non-Hispanic black (19.3%), Hispanic (13.0%), and non-Hispanic Asian (6.8%) adults.
  • The percentage of adults with chronic pain and highimpact chronic pain increased as place of residence became more rural.

Special Diets Among Adults: United States, 2015–2018

November 3, 2020

A new NCHS report  released today shows the percentage of U.S. adults who, on a given day, were on any special diet and specific types of special diets in 2015–2018 and trends from 2007–2008 through 2017–2018.

Key Findings: 

  • In 2015–2018, 17.1% of U.S. adults aged 20 and over were on a special diet on a given day.
  • More women were on a special diet than men, and more adults aged 40–59 and 60 and over were on a special diet than adults aged 20–39.
  • More non-Hispanic white adults (17.8%) were on a special diet than non-Hispanic black (14.7%) and non-Hispanic Asian (14.9%) adults.
  • The most common type of special diet reported among all adults was a weight loss or low-calorie diet.
  • From 2007–2008 through 2017–2018, the percentage of adults on any special diet, weight loss or low-calorie diets, and low carbohydrate diets increased, while the percentage of adults on low-fat or low-cholesterol diets decreased.

Breakfast Intake Among Children and Adolescents: United States, 2015–2018

October 14, 2020

Questions for Ana Terry, Health Statistician and Lead Author of “Breakfast Intake Among Children and Adolescents: United States, 2015–2018.”

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

AT: It was interesting to see that the percentage of breakfast intake among adolescents was more than 20 percentage points lower than younger children: 73% of adolescents aged 12-19 and 96% of children aged 2-5 years old consumed breakfast.


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

AT: We assessed data from the National Health and Nutrition Examination Survey, in which survey participants were asked to report all foods and beverages they consumed in the previous 24 hours, from midnight to midnight. We looked at children and adolescents, aged 2-19 years who reported eating “breakfast” (or “desayuno”).


Q: Is there any trend data that goes back further than 2009-2010?

AT: The National Health and Nutrition Examination Survey has been collecting diet intake information since 1971, for almost 50 years. We focused on breakfast consumption in the past 10 years for this report.


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

AT: Overall, we found that from 2015 to 2018, 82% of children and adolescents consumed breakfast on a given day; breakfast consumption decreased with age and was higher among children & adolescents from families with higher incomes; a lower percentage of non-Hispanic black children and adolescents consumed breakfast; and that milk, cereal, and water were the most commonly reported foods or beverages. The percentage of children and adolescents who consumed breakfast did not change in the past 10 years.


Q: Is there data on lunch and dinner?

AT: Yes, the National Health and Nutrition Examination Survey, which is the source of the data, conducts a 24-hour dietary recall, by which we gather information on all foods and beverages consumed by the participant in the previous 24 hours. Diet intake data is available for researchers to assess which meals and snacks were reported, the time of the day for each meal or snack, and the foods and beverages that were consumed. For this data brief, we focused on breakfast consumption from 2015 to 2018.


Motor Vehicle Traffic Death Rates Among Adolescents and Young Adults Aged 15–24, by Urbanicity: United States, 2000–2018

October 8, 2020

Questions for Sally Curtin, Health Statistician and Lead Author of “Motor Vehicle Traffic Death Rates Among Adolescents and Young Adults Aged 15–24, by Urbanicity: United States, 2000–2018.”


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

SC: The finding that the difference in MVT death rates between persons aged 15-24 and 25 years and over has narrowed so much since 2000 so that the rate is only 7% higher for 15-24 year-olds in 2018.


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

SC: These data are from the National Vital Statistics System and come from the information from death certificates in the United States.  All of the rates in this report are reproducible from the CDC WONDER online database.


Q: How do you classify urban and rural areas?

SC: The National Center for Health Statistics developed a scheme (the latest published in 2013) to classify the urbanicity of counties by combining information on whether the county was considered to be part of a metropolitan area and the population of the county.  Based on this, there are four categories of Metropolitan (urban) counties, from largest to smallest, and two categories of rural counties.


Q: Is this the first report on motor vehicle deaths with an urban and rural breakdown?  Is there any trend data that goes back further than 2000?

SC: A recent NCHS report examined trends in MVT deaths by urban-rural classification but it was for all ages combined.  This is the first report to focus on trends in younger adults, aged 15-24, by urban-rural.

There is MVT trends data prior to 2000, although they are not entirely comparable to the data from 1999 to the present.  However, trends from 1980-1999 rates are generally downward.


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

SC: There has been great progress in reducing death rates to young adults aged 15-24, for whom this has been a leading cause of death.  However, the disparity in rates that still exist between rural and urban counties shows that there is more work to be done, particularly in the most rural areas.

 


Reasons for Being Uninsured Among Adults Aged 18–64 in the United States, 2019

September 30, 2020

Questions for Amy Cha, Health Statistician and Lead Author of “Reasons for Being Uninsured Among Adults Aged 18–64 in the United States, 2019.”

Q: Why did you decide to do a report on this topic?

AC: In 2019, 14.5% of adults aged 18–64 were uninsured in the United States. Individuals without health insurance experience barriers to health care such as not having a usual source of care and postponing or forgoing care due to cost, which may lead to negative health outcomes. Therefore, in this report we evaluated the characteristics of uninsured adults aged 18–64 in 2019 and the percentage among uninsured adults who identified with six reasons for being currently uninsured.


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

AC: We were surprised that the percentage of adults who were uninsured due to cost was higher among women and adults in fair or poor health. The percentage who were uninsured due to cost increased with age from 66.8% among those aged 18–29 to 80.9% among those 50─64.


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

AC: The data for this report came from the 2019 National Health Interview Survey (NHIS) Sample Adult component. NHIS is a nationally representative, household survey of the civilian noninstitutionalized U.S. population. In 2019, the NHIS questionnaire was redesigned to better meet the needs of data users. The data is publicly available on the NHIS website (https://www.cdc.gov/nchs/nhis) with detailed data documentation.


Q: Is there any trend data for this report? If so, where can I find this data?

AC: We do not have any trend data for this report. With the NHIS redesign, questions concerning the reasons for being uninsured were asked in a different manner than in previous surveys and therefore are not comparable.


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

AC: Among uninsured adults aged 18–64, the most common reason for being currently uninsured was because they perceived that they could not afford the cost of coverage, followed by not being eligible, not wanting coverage, the process of signing up was too difficult or confusing, could not find a plan that meets their needs, and they signed up for coverage, but the plan has not started yet.


Prevalence of Prescription Pain Medication Use Among Adults: United States, 2015–2018

June 24, 2020

FROM THE AUTHOR

In 2015–2018, 10.7% of U.S. adults used one or more prescription pain medications in the past 30 days.  Prescription pain medication use was higher among women than men overall and within each age category. Use increased with age overall and among men and women. Prescription pain medication use was lowest among non-Hispanic Asian adults, and use among Hispanic adults was lower than among non-Hispanic white adults. This same pattern of prescription pain medication use was observed among both men and women.

Additionally, this report estimated the percentage of adults who used one or more opioid prescription pain medications (with or without use of non-opioid prescription pain medications) and the percentage who used one ore more non-opioid prescription pain medication (without use of prescription opioids).  In 2015–2018, 5.7% of U.S. adults used prescription opioids and 5.0% used non-opioid prescription pain medications (without prescription opioids) in the past 30 days. Use of one or more prescription opioids and use of non-opioid prescription pain medications (without prescription opioids) were higher among women than men, and increased with age, and were lowest among non-Hispanic Asian adults.  Use of one or more prescription opioids among Hispanic adults was lower than among non-Hispanic white adults.

From 2009–2010 to 2017–2018, there was no significant increase in use of prescription opioids, but use of non-opioid prescription pain medications (without prescription opioids) increased.

Source: National Health and Nutrition Examination Survey, 2015–2018.


Prevalence of Tooth Loss Among Older Adults: United States, 2015–2018

June 17, 2020

Questions for Eleanor Fleming, Health Statistician and Lead Author of “Prevalence of Tooth Loss Among Older Adults: United States, 2015–2018.”

Q: Why did you decide to do a report on tooth loss among older U.S. adults?

EF: Tooth loss among older U.S. adults is an important public health issue. Reducing complete tooth loss is a national health goal monitored by Healthy People. From a health perspective, tooth loss diminishes quality of life, impacts nutrition as food choices are limited, and can impede social interactions. Tooth loss is also preventable.


Q: Can you summarize how the data varied by sex, age, race and Hispanic origin, and education?

EF: While the prevalence of complete tooth loss has been diminishing since the 1960s, in other words, older adults are retaining their teeth; in 2015-2018, disparities continue to persist. Overall, the prevalence of complete tooth loss was 12.9%. We found differences in the prevalence of complete tooth loss by sex, age, race and Hispanic origin, and education.

The prevalence of complete tooth loss among adults aged 65 and over and increased with age: 8.9% (aged 65–69), 10.6% (70–74), and 17.8% (75 and over). There were also differences among women and men by age. Among women, prevalence increased in a similar pattern with age (6.9% for adults aged 65–69, 11.7% for 70–74, and 16.6% for 75 and over). There was a different pattern among men. Among men, complete tooth loss was higher in the oldest age group (19.5% for 75 and over) compared with the two younger groups (11.1% and 9.4%, respectively, for those aged 65–69 and 70–74). There were no observed significant differences in the prevalence between men and women.

By race and Hispanic origin, the prevalence of complete tooth loss is similar to patterns that we see in other oral health and health outcomes. There are differences among race and Hispanic and origin. Non-Hispanic black older adults (25.4%) had the highest prevalence of complete tooth loss compared with other race and Hispanic-origin groups. Among men, prevalence was also higher among non-Hispanic black men (23.4%) compared with non-Hispanic white (12.5%) and Hispanic (11.9%) men. Among women, prevalence of complete tooth loss was higher in non-Hispanic black women (26.8%) compared with Hispanic (17.8%) and non-Hispanic white (9.5%) women.

We also found differences in the prevalence of complete tooth loss among older adults by education level. We defined education in terms of less than a high education and a high school education or greater. Adults with less than a high school education had a higher prevalence of complete tooth loss (31.9%) compared with adults with a high school education of greater (9.5%).


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

EF: The statistical difference between Hispanic men and women was the most surprising finding in this report. It was not surprising that we observed the prevalence of complete tooth loss to be higher among Hispanic women (17.8%) compared to non-Hispanic women (9.5%). Nor, was it surprising that the prevalence of complete tooth loss among Hispanic men (11.9%) was lower compared to non-Hispanic white men (12.5%). However, a statistical difference Hispanic men and women was not expected.

When you look at the prevalence tooth loss by age among men and women, it is also striking that there were no statistical differences between men and women. While the pattern of estimates with age was difference, none of these differences were statistically different. One would hope to see either a similar pattern or statistical differences. Finding neither is striking.


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

EF: This report used National Health and Nutrition Examination Survey data, survey years 1999-2000 to 2017-2018. The survey includes an oral health examination, where dental examiners who are trained and licensed to practice in the United States conduct a tooth count. They assess whether a tooth is present or absence or all 32 teeth. We used these data to assess the absence of teeth in all teeth. Because the protocol for assess tooth count was similar in the survey years, we could combine the data. It should be noted, however, that protocols for the tooth count were similar, the dental examiners were not always dentists; licensed dental hygienists collected data for certain survey cycles.


Q: Is there any trend data that goes back further than 1999?

EF: This report includes trend data starting at 1999 with continuous data, meaning that survey has collected data continuously. While the oral health component has been part of the survey since its inception in 1959, we focused on these more recent, continuous data.

From 1999–2000 through 2017–2018, the age-adjusted prevalence of complete tooth loss decreased from 29.9% to 13.1%. The prevalence has decreased for both men and women.


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

EF: Overall, the prevalence of complete tooth loss among adults aged 65 and over was 12.9%, and the age-adjusted prevalence has decreased since 1999-2000. This is great news, as more older adults are retaining their teeth. However, for 12.9% of older adults to be without their teeth has tremendously public health importance and signals that additional work is needed.


Sexual Activity and Contraceptive Use Among Teenagers Aged 15-19 in the United States, 2015-2017

May 6, 2020

Questions for Gladys Martinez, Health Statistician and Lead Author of “Sexual Activity and Contraceptive Use Among Teenagers Aged 15-19 in the United States, 2015-2017.”

Q: Why does NCHS conduct studies on sexual activity and contraception?

GM: We conduct studies on sexual activity and contraceptive use to better understand the risk for sexually transmitted diseases, birth and pregnancy rates, and differences between groups in the U.S. reproductive age population.

For this report they are crucial for understanding differences in the risk of teen pregnancy and to put into context recent declines in the U.S. teen birth rate.


Q: Can you summarize how the data varied by sex and age groups?

GM: There has been a decline in the percentage of male and female teens who ever had sex from 1988 to 2017.  But the percentage of male teens who ever had sex continues to decline in most recent time period 2011-2015 to 2015-2017, but has remained the same for female teens.

Male and female had similar:

  • cumulative probabilities of having had sex at each age in their teen years
  • relationship between age at first sex and contraceptive use: teens with younger ages at first sexual intercourse were less likely to use a method of contraception

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

GM: For the first time since we have been collecting these data, the cumulative probabilities of having had sex by each age in the teen years were similar for young males and females.

Ever use of implant is 15% which is an increase from 2011-2015 when it was only 3%.


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

GM: Data for this report are from the 2015-2017 National Survey of Family Growth, a nationally representative in-person survey of men and women aged 15-49 in the United States.


Q: Do you have older data that is comparable beyond 2002?

GM: Yes, we have been tracking these data since the 1970s and the earliest published NSFG report shows data from 1988.