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.

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High-deductible Health Plan Enrollment Among Adults Aged 18-64 With Employment-based Insurance Coverage

August 9, 2018

Questions for Robin Cohen, Ph.D. and Lead Author of “High-deductible Health Plan Enrollment Among Adults Aged 18-64 With Employment-based Insurance Coverage

Q: What made you decide to put together a report about high and low deductible health plans for adults with employment-based coverage?

RC: We decided to produce an analysis focusing on high-deductible health plans (HDHPs) after observing how enrollment in HDHPs has increased over the past decade. In addition, HDHP enrollment growth has been faster among those with employment-based coverage than among those with directly-purchased coverage, so it also made sense to highlight employment-based insurance plans in this study. This report examines differences in the demographic characteristics for those with employment-based coverage by plan type.    


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

RC: It was the dramatic increase in high-deductible health plan (HDHP) enrollment in recent years that really surprised us. We hadn’t expected to see such a large jump, which was most notable among those with a health savings account (HSA). The percentage of adults aged 18 to 64 enrolled in an HDHP with an HSA more than quadrupled in the past decade from 4.2% to 18.9%.


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

RC: Both the differences among age groups and the lack of variance by sex in this study’s findings are notable. Among adults aged 18 to 64 with employment-based coverage, there were no differences in the type of health insurance plan by sex. Enrollment in a high-deductible health plan with a health savings account was higher among adults aged 30 to 44 than those aged 18 to 29 and 45 to 64.


Q: What is the significance of having a health savings account and not having one when you have a high-deductible health insurance plan?

RC: A health savings account (HSA) allows pretax income to be saved to help pay for the higher costs associated with a high-deductible health plan (HDHP). However, this report did not examine the association of having an HDHP — coupled with an HSA — on service use and financial burden for medical care.

 

Q: Is it a choice for Americans to have a health savings account? Can anyone have one?

 

RC: A health savings account (HSA) must be coupled with a high-deductible health plan (HDHP), but not everyone enrolled in an HDHP has an HSA. High-deductible health plans with HSAs are offered to individuals both by employers and in the direct-purchase health insurance market.

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

 

RC: I think the real take-home message in this Data Brief is the role that education and income play in health insurance coverage with these types of high-deductible health plans (HDHPs). More highly educated and affluent adults were more likely to enroll in an HDHP with a health savings account (HSA) and less likely to enroll in a traditional plan or an HDHP without an HSA — than their less educated and less affluent counterparts. The National Health Interview Survey will continue to monitor different types of private health insurance, and the survey can be used to examine further differences according to plan type.

Q: Do you have trend data on high-deductible health plans going back further than 2007?

RC: No, we don’t have earlier than 2007 trend data on high-deductible health plans (HDHPs). The National Health Interview Survey began to collect data on enrollment in HDHPs starting in 2007.


Trends in Liver Cancer Mortality Among Adults Aged 25 and Over in the United States, 2000-2016

July 17, 2018

Jiaquan Xu, M.D., NCHS Epidemiologist

Questions for Lead Author Jiaquan Xu, M.D., Epidemiologist, and Author of “Trends in Liver Cancer Mortality Among Adults Aged 25 and Over in the United States, 2000-2016

Q: What made you decide to focus on liver cancer deaths for this study?

JX: It was the dramatic rise in the death rate for liver cancer that caused me to want to look more deeply into various aspects of this marked change and produce this new report. I also wanted to offer state-by-state data for liver cancer mortality, so that the U.S. Public Health Community might have information that will help them in their important work throughout America. While we have seen decreases in death rates from many major causes — such as heart disease, cancer (all cancer combined), and stroke recently – liver cancer deaths stand out far away from the decreasing trends of these causes of death. To elaborate, the age-adjusted death rates for all cancer combined, have declined since 1990. Also, for the top six cancer death causes in 2016 (lung cancer, colorectal cancer, pancreatic cancer, breast cancer, prostate cancer, and liver cancer), the age-adjusted death rates decreased for four of them (lung, colorectal, breast, and prostate) and increased for two (liver cancer and pancreatic cancer) — with the liver cancer death rate increasing much faster than the pancreatic cancer death rate, since 2000.


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

JX:  There actually are quite a few interesting results in this new analysis that surprised me. While there are some reports out there that show the increase of liver cancer mortality, we also know that the liver cancer death rate demonstrates a trend of continued rate increase during the period from 2000 through 2016 – which is the time span this report analyzed. The surprise is that the liver cancer death rate for men is between 2 and 2.5 times the rate for women aged 25 and over, during the period of 2000–2016. Within the four race/ethnic groups analyzed, the only decrease trend in liver cancer mortality observed, is for the non-Hispanic Asian or Pacific Islander (API) group. The rate increased for non-Hispanic white, non-Hispanic black, and Hispanic persons. Also the liver cancer death rates varied quite a bit by state, which is another surprising finding.


Q: What made you decide to focus on the age group of adults 25 years old and older?

JX: I had a number of reasons to focus on the liver cancer death rate for adults aged 25 and over. More than 99% of all deaths with liver cancer reported on the death certificate are for adults 25 years of age and over. It made sense to focus this analysis on the majority age group that dies from this cancer cause. We also know that age is a leading risk factor for the development of many types of cancer. Aging increases cancer risk. This is exactly what we see here in this new report. And the liver cancer death rate for older age groups is significantly higher than the rate for younger age groups throughout the period examined in this analysis.


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

JX:  The differences among demographic groups is also what I found most surprising in this report. The liver cancer death rate for men aged 25 and over is between 2 and 2.5 times the rate for women. The liver cancer death rate varies by race/ethnic groups. The Non-Hispanic Asian or Pacific Islander (API) group have the highest liver cancer death rate among the four race/ethnic groups analyzed during 2000–2014. The rate for Hispanic adults surpassed the rate for non-Hispanic API and became the highest in 2016. The liver cancer death rate for non-Hispanic white adults was the lowest among the race/ethnic groups throughout the period (2000–2016).


Q: Why do you think there is such a vast difference among the states in death rates from liver cancer?

JX: The mortality data we analyzed does not provide any evidence itself to show the reason or reasons that could contribute to the variation of liver cancer death rates by state. In general, the majority of the liver cancer in the United States is often attributed to some potential risk factors such as metabolic disorders (including obesity, diabetes, and nonalcoholic fatty liver disease), chronic Hepatitis C (HCV) infection, excessive consumption of alcohol, smoking, and chronic Hepatitis B (HBV) infection. If the number of people affected by those potential risk factors is different from one state to another, the liver cancer incidence rate and death rate would vary.


Q: What do you think is the reason for the growing increase in deaths from liver cancer in the United States?

JX: The mortality data we analyzed does not provide any evidence itself to show the reason or reasons that could contribute to the rising of the liver cancer death rate in this country. Some risk factors might contribute to the increase in liver cancer incidence rate and death rate. For example, some attribute the baby boomer generation’s higher hepatitis C virus infection rate than other adult age groups. Some have identified an increase in the obesity rate as another reason. Unfortunately, we can’t answer this question with our data, though it is an important question.


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

JX: I think the real take-home message of this Data Brief is what it can offer to the Public Health Community to learn about liver cancer mortality variance among different groups. The report shows that liver cancer mortality varies by sex, age, race/ethnic groups, and by state. Although the overall liver cancer death rate increased from 2000 to 2016, the rate for non-Hispanic Asian or Pacific Islander (API) decreased. The rate for adults aged 45–54 has decreased since 2012.


Prevalence of Total and Untreated Dental Caries Among Youth: United States, 2015–2016

April 13, 2018

Eleanor Fleming, Ph.D., D.D.S., M.P.H., Dental Epidemiologist

Questions for Eleanor Fleming, Ph.D., D.D.S., M.P.H., Dental Epidemiologist and Lead Author of “Prevalence of Total and Untreated Dental Caries Among Youth: United States, 2015–2016

Q: What made you decide to focus on the prevalence of dental cavities in young children for this study, versus other dental conditions like gum disease or tooth grinding – or some other critical public health concerns today for America’s youth?

EF: Our intent in conducting this study was to provide up-to-date prevalence estimates for dental caries in children. We decided that our study would focus on dental caries because of the serious and negative impact untreated caries can have on children. By the way, dental “caries” is the scientific term for tooth decay or cavities. Dental caries are the most common chronic disease among youth aged 6-19 years. Untreated caries cause pain and infection. Children miss days from school and have their overall quality of life effected by untreated dental caries. This is an important public health concern for America’s youth. While dental conditions like gum disease or tooth grinding are important, the National Health and Nutrition Examination Survey (NHANES) Oral Health Component does not currently collect data on these dental conditions. The component focuses on collecting data on tooth loss, dental caries, and dental sealants.


Q: In your new report, you examine differences in the prevalence of tooth cavities by income level; what is the motivation to look at income, since many children’s dental care might be paid by either public or private health insurance?

EF: We examined family income in this study for a few reasons. One is that income is a significant social determinant of health. For our study, we decided to include family income in addition to age, race and Hispanic origin. We were curious about the differences in untreated and total caries (tooth decay) by family income level. For both total and untreated caries, prevalence decreased as family income level increased. There is also concern among the public health community that children who may have access to Medicaid dental benefits are not receiving the care that they need. The examination of income levels in our new report might offer some needed insight to this concern.

The prevalence of total dental caries decreased as family income levels increased, from 51.8% for youth from families living below the federal poverty level to 34.2% for youth from families with income levels greater than 300% of the federal poverty level.

The prevalence of untreated dental caries decreased from 18.6% for youth from families living below the federal poverty level to 7.0% for youth from families with incomes greater than 300% of the federal poverty level.


Q: Was there a result in your study that you hadn’t expected and that really surprised you?

EF: Because our motivation for this study was to provide updated national estimates on untreated and total caries (tooth decay) for 2015-2016, all of the results were very interesting in one way or another — and surprising. National estimates for age, race and Hispanic origin, and income are results that we need to understand for public health surveillance purposes. For me though, the overall estimates for youth by age were especially interesting.

While the untreated dental caries prevalence overall for youth is 13.0%, there were age differences that caught my eye. The low prevalence for 2-5 year-olds is an important and encouraging finding. While we don’t know if it is from prevention efforts, access to care, or other factors, the fact that our youngest youth have the lowest untreated and total caries prevalence shows they’re starting off their young lives with healthy teeth.

The prevalence was lowest in youth aged 2-5 years (8.8%) compared with youth aged 6-11 years (15.3%) and 12-19 years (13.4%). The prevalence of the 6-11 and 12-19 years-olds was significantly different from the prevalence of 2-5 year-olds.

The total caries experience was also lowest for youth aged 2-5 years (17.4%) compared to youth aged 6-11 years (45.2%) and 12-19 years (53.5%). As age increased, the total caries prevalence increased.


Q: What, if any, is the difference between the two terms you use in your report – primary teeth and permanent teeth?

EF: Primary teeth are baby teeth, or the first teeth that erupt, or come in, which are later shed and replaced by permanent teeth. Primary teeth erupt from around 6 months to age 2 or 3 years. The permanent teeth replace the primary teeth. These teeth start coming in around the age of 6 years and continue until the third molars, or wisdom teeth come in, somewhere between the ages of 17 to 21 years. In our analysis, we combined the two types of teeth in order to focus on dental caries (tooth decay) regardless of tooth type.


Q: In your report, are untreated dental cavities a subset of the number of total cavities, and therefore included in the total cavity statistics?

EF: Yes, untreated dental caries (tooth decay) are included in the total number of dental caries. When we describe total dental caries, we are focused on both untreated and treated dental caries. Essentially, the total of dental caries take into account any tooth decay experience that someone has had. Untreated dental caries represent tooth decay that has not been treated. Untreated dental caries are also known as cavities. What we capture in the untreated caries measure is the active disease of youth.


Q:  What differences or similarities did you see among race and ethnic groups, and various demographics, in this analysis?

EF: We noted a number of differences among youth by race and Hispanic origin in this analysis. Non-Hispanic black youth had the highest prevalence of untreated caries (tooth decay) (17.1%) compared to other race and Hispanic-origin groups. The prevalence for non-Hispanic black youth was significantly different from non-Hispanic whites (11.7%) and non-Hispanic Asians (10.5%). The prevalence of untreated dental caries in Hispanic youth was 13.5%.

Hispanic youth had the highest prevalence of total caries (52.0%) compared to other race and Hispanic-origin groups. The prevalence was also significantly different from non-Hispanic whites (39.0%) and non-Hispanic Asians (42.6%). The prevalence of total caries for non-Hispanic black youth was 44.3%.


Q: What sort of trend data do you have on this topic so we can see how prevalence has evolved over time?

EF: With six years of data, we can look at the trend in prevalence over time. Because dental caries (tooth decay) is the most common condition of childhood, we thought it was important to include trend analysis in our report.

The results show a significant linear decrease in total caries. From 2011-2012 to 2015-2016, the total caries prevalence decreased from 50.0% to 43.1%. The results show a different pattern for untreated dental caries. The prevalence of untreated dental caries increased from 2011-2012 (16.1%) to 2013-2014 (18.0%), and then decreased in 2015-2016 (13.05). There is significant quadratic trend – a single bend either upward or downward — in untreated dental caries from 2011-2012 to 2015-2016.


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

EF: The take-home message from this report is that there are differences in untreated and total caries (tooth decay) by age group, race and Hispanic origin, and income. The trend analysis shows that the prevalence of untreated and total caries are decreasing. However, there are still disparities that exist. Because monitoring prevalence of untreated and total caries is key to preventing and controlling oral diseases, these disparities are important.

The prevalence of untreated dental caries in America’s youth is 13.0%. The prevalence decreased as family income increased, with youth with family incomes less than 100% of the federal poverty level having the highest prevalence. Disparities in untreated dental caries exist along race and Hispanic origin. Non-Hispanic black youth have the highest prevalence compared to Hispanic, non-Hispanic white, and non-Hispanic Asian youth.


Emergency Department Visits by Patients aged 45 and over with Diabetes: United States, 2015

February 8, 2018

Questions for Pinyao Rui, Statistician and Author of, “Emergency Department Visits by Patients aged 45 and over with Diabetes: United States, 2015.”

Q: Why did you decide to examine emergency department (ED) visits made by patients aged 45 years older with diabetes?

PR: We decided to examine emergency department visits made by patients aged 45 years and older because we wanted to focus on visits made by older patients who are at higher risk of developing or having diabetes and who comprise a majority of all diabetes cases in the U.S.  Additionally, we wanted to use more recent data not currently available in the literature to examine characteristics of an ED visit for a condition that is projected to rise and contribute to increasing burden of medical care systems.


Q: How did the rate of emergency department visits by patients aged 45 and over with diabetes change with age?

PR: The rate of emergency department visits by patients aged 45 and over increased with age. The rate increased from 69 per 1,000 persons for those aged 45-64 years and more than doubled to 164 per 1,000 persons for those aged 75 years and over.


Q: Were there differences in the percentage of visits that ended in inpatient hospital admission by diabetes status?

PR: Yes, the percentage of ED visits with diabetes that ended in inpatient hospital admission was significantly higher than the percentage of ED visits without diabetes among visits made by patients aged 45-64 and 65 and over.


Q: Are there any findings that surprised you from this report?

PR: One finding from the report that surprised me was that among ED visits made by 45-64 year olds, a higher proportion of diabetes visits were paid by Medicare compared with visits made by patients without diabetes (24% versus 14%).


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

PR: I think the take home message is that the percentage of ED visits by older patients with diabetes reported in the medical record has been increasing in recent years with the highest proportion observed in patients aged 65-74 (32% in 2015).


Q and As on “Mortality in the United States, 2016” and “Drug Overdose Deaths in the United States, 1999-2016”

December 21, 2017

Questions for Bob Anderson, Chief of the Mortality Statistics Branch, on the following reports, “Mortality in the United States, 2016” and “Drug Overdose Deaths in the United States, 1999-2016.”

Q: How significant is it that life expectancy¹ in the U.S. has declined two years in a row?

A:  This is the first time life expectancy for the U.S. as a whole has declined two years in a row since 1962 and 1963, years in which there were severe flu outbreaks – and an increase in deaths from flu and pneumonia – in the U.S.


Q:  Since this is very rare, do we have any idea why this decline in life expectancy has happened again?

A:  We first have to look at the leading causes of death and see what is happening there.  For 7 out of the 10 leading causes of death in the U.S., mortality actually declined between 2015 and 2016.  But mortality from 3 causes of deaths increased.  Suicide rates increased 1.5% in 2016, and mortality from Alzheimer’s disease increased 3.1%.  However, mortality from accidents/unintentional injuries increased at a rate over three times that the increase of Alzheimer’s disease mortality – a 9.7% increase between 2015 and 2016.   And many of these accidental/unintentional deaths were from drug overdoses.


Q: How many deaths in 2016 were attributed to opioids?

A: In 2016, 42,249 drug overdose deaths mentioned involvement of any type of opioid, including heroin and illicit opioids.


Q: Why is the 63,632 number of overdose deaths smaller than what CDC has previously reported for 2016?

A: The 63,632 number is a final, official number of overdose deaths among U.S. residents for 2016 whereas the previously reported (and slightly higher) numbers were provisional estimates.

BACKGROUND:  In August of this year, CDC began calculating monthly provisional data on counts of drug overdose deaths as a rapid response to this public health crisis, in order to provide a more accurate, closer to “real-time” look at what is happening both nationally and at the state level.  These monthly totals are provisional counts, and they include all deaths occurring in the U.S. – which include deaths among non-residents (i.e., visitors here on business or leisure, students from abroad, etc).  These counts also do not include deaths that are still under investigation.  As a result, the monthly numbers are provisional or very preliminary, and the final 2016 number of 63,632 deaths is an official number that only include deaths among U.S. residents and account for any previously unresolved deaths that were under investigation.


Q: In comparing the 2016 numbers with 2015 and past years, is the crisis of drug overdose deaths growing or about the same?

A: From 2015 to 2016, the number of drug overdose deaths increased from 52,404 deaths to 63,632 deaths, a 21% increase.  Over a longer period of time, from 1999 through 2016, the age-adjusted rate of drug overdose deaths increased on average by 10% per year from 1999 to 2006, by 3% per year from 2006 to 2014, and by 18% per year from 2014 to 2016.  So this is a continuing, disturbing upward trend.


Q: Are there any other trends of significance when looking at the types of drugs attributed to overdose deaths?

A: The rate of drug overdose deaths involving synthetic opioids other than methadone, which include drugs such as fentanyl, fentanyl analogs, and tramadol, doubled in one year, from 3.1 per 100,000 in 2015 to 6.2 per 100,000 in 2016. In 2016, 30% of all drug overdose deaths mentioned involvement of a synthetic opioid other than methadone.


Q: Has fentanyl overtaken heroin as a major cause of overdose death?

A: The data brief on drug overdose deaths does not specifically address fentanyl. However the rate of drug overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, doubled between 2015 and 2016. In 2016, the rate of drug overdose deaths involving synthetic opioids other than methadone was 6.2 per 100,000 and the rate of drug overdose deaths involving heroin was 4.9 per 100,000.


Q: There is a lot of stark news in these two reports.  Are there any positives to report?

A: As mentioned, mortality from 7 out of the 10 leading causes of death in the U.S. declined in 2016; in fact, the overall mortality rate for the U.S. actually dropped despite the decline in life expectancy.  As for drug overdose deaths, the rate of increase in drug overdose deaths involving natural and semi-synthetic opioids, such as oxycodone and hydrocodone, is slowing. From 1999 to 2009, the rate increased on average by 13% per year but from 2009 to 2016, the rate increased by 3% per year.  And from 2006 to 2016, the rate of drug overdose deaths involving methadone decreased from 1.8 per 100,000 to 1.0 per 100,000.

The 2015 life expectancy estimate was revised to 78.7 years, down from 78.8 years, which was reported a year ago.

¹BACKGROUND: As a routine matter, for the highest degree of accuracy we blend Medicare data for people ages 66 and over with our vital statistics data to get a final, official estimate of life expectancy.  However, the two data sets are released on different schedules and occasionally, as with the 2015 estimates, the Medicare data for that year isn’t available at the time we release our final mortality statistics.


Sleep Duration and Quality Among Women Aged 40-59, by Menopausal Status

September 7, 2017

Questions for Anjel Vahratian, Ph.D., Author of “Sleep Duration and Quality Among Women Aged 40-59, by Menopausal Status

Q: What made you decide to conduct this study on sleep duration and sleep quality for this group of women?

AV: My research focuses on the health of women as they age and transition from the childbearing period. During this time, women may be at increased risk for chronic health conditions such as diabetes and cardiovascular disease. As insufficient sleep is a modifiable behavior that is associated with these chronic health conditions, I wanted to examine how sleep duration and quality varies by menopausal status.


Q: Was there a finding in your new study that surprised you, and if so, why?

AV: I was surprised to learn that nearly one in two women aged 40-59 did not wake up feeling well rested four times or more in the past week and that postmenopausal women aged 40-59 were more likely to experience disruptions in sleep quality compared with premenopausal women in the same age group.


Q: How did the women from your survey track their sleep behavior; for example, did they use a wearable sleep tracker?

AV: In this report, information on sleep duration and quality are based on self-report. Trained interviewers asked survey participants on average, how many hours of sleep did they get in a 24-hour period. In addition, they asked participants to recall how many times they had problems falling asleep and staying asleep and how many days they woke up not feeling well rested in the past week.


Q: In addition to menopausal status, do you have any other lifestyle information that could impact women’s sleep quality for this age group; for example, shift work employment or having infants or very young children in the home?

AV: While this report did not specifically look at other lifestyle factors that could affect women’s sleep duration and quality – other than age and menopausal status — my colleagues released a report in January 2016 on sleep duration and quality by sex and family type. This report looked at the presence of young children in the household. In addition, we have produced estimates of sleep duration and quality across several sociodemographic characteristics such as race and ethnicity, education, poverty status, marital status, and region.


Q: This report seems to offer just a single year of data – 2015; do you have any trend data to compare these findings to previous years, or any newer data?

AV: Unfortunately, we do not have any long-term trend data on sleep duration and quality among women aged 40-59 by menopausal status. The National Health Interview Survey, or NHIS, has included questions on sleep duration and quality since 2013, while the questions on menopausal status were a part of the 2015 NHIS cancer control supplement.


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

AV: I think the real take-home message of this report is that sleep is critical for optimal health and wellbeing, and it is a modifiable risk factor for diabetes and cardiovascular disease. As sleep duration and quality vary by menopausal status, it is an area for targeted health promotion for women at midlife.