NCHS Releases Health, United States: 2018

October 30, 2019

National fertility rates have been declining steadily for over a decade, and life expectancy at birth has also declined in recent years, according to the latest annual report on the nation’s health, released today by CDC’s National Center for Health Statistics.

The report, “Health, United States: 2018” features charts and online tables of health-related data on a wide range of topics, including health care, immunization, and health behaviors, providing a comprehensive snapshot of the nation’s health:

  • Fertility rates (the number of live births per 1,000 females ages 15-44) have fallen 10 out of the last 11 years in the United States.
  • The birth rate among teenagers ages 15–19 years fell by more than one-half, from 41.5 in 2007 to 18.8 live births per 1,000 teens in 2017—a record low for the United States. 2018 data indicate that this trend has continued.
  • The infant mortality rate in the United States dropped in 2017, from 5.9 infant deaths per 1,000 live births in 2015 and 2016 to 5.8 in 2017. The infant mortality rate in the U.S. has declined by more than five-fold since 1950.
  • From 2007 to 2018 (preliminary estimates), the percentage of children under 18 years with no health insurance decreased 3.8 percentage points to 5.2%.
  • In 2017, fewer than half (48.5%) of uninsured children ages 19–35 months had received the recommended combined 7-vaccine series. This was significantly lower than among the percentage of children who were covered by private health insurance (76.0%) or Medicaid (66.5%).
  • The use of e-cigarettes among students in grades 9–12 increased from 1.5% in 2011 to 20.8% in 2018, nearly doubling (from 11.7% in 2017) in the last year alone.
  • In 2017, 16.2% of adults living below 100% of the poverty level delayed or did not receive needed medical care due to cost compared with 5.1% of those living at or above 400% of the poverty level.
  • The percentage of Americans taking 5 or more prescription drugs in the past 30 days increased from 6.5% in 1999–2000 to 10% in 2003–2004, and then was stable through 2015–2016 (11%).¹
  • In 2017, personal health care expenditures in the United States totaled almost $3.0 trillion—a 3.8% increase from 2016. • From 2007 to 2017, the death rate from drug overdoses increased 82%, from 11.9 to 21.7 deaths per 100,000.¹
  • From 2007 to 2017, the suicide rate for children ages 10–14 increased from 0.9 to 2.5 deaths per 100,000 resident population. From 2007 to 2017, the suicide rate increased 24%, from 11.3 to 14.0 deaths per 100,000 resident population.¹
  • Life expectancy at birth in the U.S., after increasing or remaining the same in every year between 1994 and 2014, has declined in two of the past three years. Significant decreases in life expectancy have been observed each year since 2015 among men, while remaining stable among women.

¹Rates are adjusted for age.


Health, United States, 2017

September 20, 2018

Renee Gindi, Ph.D., Chief, Analytic Studies Branch, Office of Analysis and Epidemiology

Questions for Renee Gindi, Ph.D., Chief, Analytic Studies Branch, Office of Analysis and Epidemiology, who led production of “Health, United States, 2017

Q: Why did you produce this report?

RG: We produced this report for a number of reasons. Health, United States, 2017 with Special Feature on Mortality is the 41st edition of the Congressionally-mandated annual report on the health of the nation from the Secretary of the Department of Health and Human Services to the President of the United States and to Congress.

This report benefits the public health community and the general public by bringing key national health data from different sources into one location. In this wide-ranging report, users can find graphs, tables, and descriptions of trends and current information on selected measures of health and disease. The Special Feature section of the report more closely examines a topic of public health interest and policy relevance.

Q: What made you decide to focus on deaths in the United States as the Special Feature for this study?

RG: It was the recent decrease in life expectancy at birth that caused us to want to look more deeply into what groups were most affected by this marked change. Life expectancy at birth decreased for the first time since 1993 by 0.2 years between 2014 and 2015 and then decreased another 0.1 years between 2015 and 2016. We found that between 2000 and 2016, death rates for 5 of the 12 leading causes of death increased: unintentional injuries, Alzheimer’s disease, suicide, chronic liver disease, and septicemia.


Q: Was there a finding in this edition of “Health, United States” that you hadn’t expected and that really surprised you?

RG: In addition to the decrease in life expectancy at birth, we found several trends that were particularly noteworthy. Here are a few of them:

  • The increases (and acceleration of those increases) in death rates for specific causes of death in specific age groups:
    • In particular, drug overdose death rates among men aged 25–34 increased by an average of 26.7% per year during 2014-2016. For women aged 15-24, drug overdose death rates increased by an average of 19.4% per year during 2014-2016.
    • The suicide rate among children and young adults aged 15-24 has been increasing since 2006, with a recent increase of 7.0% per year during 2014-2016.
    • The rate of deaths from Alzheimer’s among adults aged 65 and older has also been increasing, by an average of 6.9% per year during 2013-2016.
  • Current cigarette smoking has been decreasing among adults (18+), with declines observed in every age group in recent years.
  • Among adolescents, cigarette smoking in the past 30 days has decreased between 2011 and 2016, but e-cigarette use in the past 30 days has increased more than seven-fold, from 1.5% in 2011 to 11.3% in 2016.
  • The rate of births to teen mothers has been decreasing in recent years among all races and ethnic groups examined.

Q: What is new in the report this year?

RG: There are a couple of new items worth highlighting from this year’s edition of Health, United States. The Special Feature on mortality, with its look at when, why, and where individuals are dying in the United States, is a new focus this year.

Also new this year is the examination of trends in disability and functional limitation using a new data source, the Washington Group Short Set on Functioning (WG-SS). These questions are considered the international standard and replace the questions used to describe disability in previous editions of Health, United States.

Health, United States, 2017 includes information on the functional status of civilian noninstitutionalized adults. Level of difficulty in six basic, universal domains—seeing, hearing, mobility, communication, cognition (remembering or concentrating), and self-care—identify the population with disability, namely those at greater risk than the general population for participation restrictions due to these, if appropriate accommodations are not made. Functional status is summarized using three mutually exclusive categories: “a lot of difficulty” or “cannot do at all/unable to do” in at least one domain; “some difficulty” in at least one domain but no higher level of difficulty in any domain;  and those with “no difficulty” in all domains.


Q: What does this publication tell us about the health of our nation?

RG: This year’s Health, United States publication tells us a lot about the health of our nation. The overall age-adjusted death rate has decreased between 2006 and 2016 by 8%, from 791.8 to 728.8 deaths per 100,000 resident population. However, the majority of deaths (73%) are among persons aged 65 and older. The death rates for nearly all of the leading causes of death in this age group have been decreasing since 2006, including heart disease and cancer, the two leading causes of death in this age group.

However, the death rates in other age groups paint a different picture. Among persons aged 15-24, 25-44 and 45-64, death rates for several causes have been increasing in recent years—including unintentional injuries, suicide, homicide, and chronic liver disease.


Health, United States Spotlight Infographics – December 2017

December 13, 2017

A new Health, United States Spotlight Infographic from the National Center for Health Statistics is now available online. This infographic features data on teenage childbearing, tobacco use, suicide deaths and obesity.

Health, United States Spotlights are infographics of selected health data available in Health, United States, the annual report on the health of the nation sub

mitted by the Secretary of the Department of Health and Human Services to the President and Congress.

Content includes selected indicators on important public health issues from the report’s four subject areas: health status and determinants, utilization of health resources, health care resources, and health care expenditures and payers. Like the report, the Spotlights display the most current data available and, where possible, trends over a ten-year period.

For some indicators, a different set of data years or combined years of data may be shown, depending on survey cycles and design changes. Data sources are identified for each health indicator to enable further exploration and include data systems from both the National Center for Health Statistics and partnering government and private agencies. Changes over time and differences among groups are presented using standard statistical techniques used in Health, United States.

Each Spotlight displays approximately four health indicators allowing users to visualize and interpret complex information from different data systems and Health, United States subject areas. Multiple infographics will be released throughout the year to spotlight important and relevant health data from Health, United States.

For more information on past and present infographics, please visit: https://www.cdc.gov/nchs/hus/hus_infographic.htm.


40th Annual Report on the Health of the Nation Features Long-Term Trends in Health and Health Care Delivery in the United States

June 28, 2017

CDC today released Health, United States, 2016, the 40th annual report on the health of the nation from the Secretary of Health and Human Services (HHS) to the President and Congress.

This year’s report features a Chartbook on Long-Term Trends in health and health care delivery over the past 40 years. From declines in cigarette smoking and increases in prescription drug use to changes in expenditures for hospitals and home health care, the annual report also explores population changes that have affected patterns of disease, as well as health care access and utilization since 1975. The 27 charts and 114 tables present birth rates and infant mortality, life expectancy and leading causes of death, health risk behaviors, health care utilization and insurance coverage, and health expenditures.

Among the highlights:

  • Between 1975 and 2015, life expectancy increased for the total population and for males and females. However, between 2014 and 2015, life expectancy declined by 0.1 years for the total population, 0.2 for males, and 0.1 for females.
  • The infant mortality rate decreased 63 percent, from 16.07 to 5.90 deaths per 1,000 live births between 1975 and 2015.
  • Between 1975 and 2015, the age-adjusted heart disease death rate decreased 61 percent from 431.2 to 168.5 deaths per 100,000 population. The age-adjusted cancer death rate decreased 21 percent from 200.1 to 158.5 deaths per 100,000 population. Heart disease and cancer remain the top two causes of death in the United States.
  • Between 1974 and 2015, the age-adjusted prevalence of current cigarette smoking declined from 36.9 percent to 15.6 percent among persons aged 25 and over.
  • The age-adjusted percentage of adults aged 20 and over with obesity increased steadily from 22.9 percent in 1988–1994 to 37.8 percent in 2013–2014.
  • Prescription drug use increased for all age groups between 1988-94 and 2013-14. Among adults 65 and over, use of five or more prescription drugs in the past 30 days increased from 13.8 percent to 42.2 percent during the same period.
  • The percentage of persons with an overnight hospital stay was lower in 2015 than in 1975 for males and females under age 75, and was not significantly different in 2015 than in 1975 for males and females aged 75 and over.
  • Between 1975 and 2014, the number of community hospital beds per 1,000 resident population fell by almost one-half from 4.6 to 2.5. The average length-of-stay per hospital stay fell by almost one-third from 7.7 to 5.5 days, and occupancy rates declined almost 16 percent from 75.0 percent to 62.8 percent.

The complete report and related data products are available on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm


New Infographic Featuring Data on Medical Care Access, Flu Vaccination and Dentists

May 1, 2017

The fourth Health, United States Spotlight from the National Center for Health Statistics is now available online. This infographic features data on medical care access, supply of dentists, and flu vaccination coverage.

The Health, United States Spotlight is released throughout the year and features indicators available in Health, United States—an annual report on the nation’s health submitted by the Secretary of the Department of Health and Human Services to the President and Congress. Each infographic provides up-to-date estimates, technical notes, description of trends, and data highlights in a visual format.

For more information on past and present infographics, please visit: https://www.cdc.gov/nchs/hus/hus_infographic.htm.


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-September 2016

February 14, 2017
Michael Martinez, M.P.H., M.H.S.A., Epidemiologist and Health Statistician

Michael Martinez, M.P.H., M.H.S.A., Epidemiologist and Health Statistician

Questions for Michael Martinez, M.P.H., M.H.S.A., Epidemiologist, Health Statistician and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-September 2016

Q: What do you think is the most significant finding in your new study?

MM: I think the most significant finding in this study is the snapshot view of varied health insurance types. While from January through September 2016, among adults aged 18 to 64, 12.3% were uninsured at the time of interview, 20.3% had public coverage, and 69.0% had private health insurance coverage. Among the 136.0 million adults in this age group with private coverage, 9.3 million–or 4.7%–were covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges during the first 9 months of 2016.


Q: How did health insurance coverage in the United States compare in the first 9 months of 2016 to 2015 and 2010?

MM: We’ve observed a number of changes in health insurance coverage between 2010 and 2015 compared to the first 9 months of 2016. Between 2010 and the first 9 months of 2016, 20.4 million persons of all ages gained coverage. In the first 9 months of 2016, 28.2 million (8.8%) persons of all ages were uninsured at the time of interview, compared with 48.6 million (16.0%) persons in 2010 and 28.6 million (9.1%) persons in 2015. The difference in uninsured estimates between 2015 and the first 9 months of 2016 was not significant.


Q: Where do high-deductible plans through private health insurance fit into 2016 estimates compared to earlier years?

MM: Among private health insurance plans, enrollment in high-deductible health plans has been increasing in recent years. 39.1% of persons under age 65 with private health insurance were enrolled in high-deductible health plans in the first 9 months of 2016. This percentage has increased significantly, from 25.3% in 2010 and from 36.7% in 2015.


Q: What are the trends among race and ethnicity groups in health insurance coverage this year and compared over time?

MM: There’s been quite a bit of change in health insurance coverage among race and ethnicity groups over the years. For example, in the first 9 months of 2016, 24.7% of Hispanic, 15.1% of non-Hispanic black, 8.5% of non-Hispanic white, and 7.8% 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 between 2013 and the first 9 months of 2016 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 between 2013 (40.6%) and the first 9 months of 2016 (24.7%).


Q: How is health insurance coverage looking this year for our youngest population – children under 18 years of age?

MM: From January through September 2016, among children under 18 years of age, 5.0% were uninsured at the time of interview, 43.4% had public coverage, and 53.5% had private health insurance coverage. Among the 39.3 million children under 18 years of age with private coverage, 1.7 million or 2.3% were covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges during the first 9 months of 2016.


Health, United States Spotlight Infographics September 2016

September 21, 2016

hus_0916_screenshotHealth, United States Spotlights are infographics of selected health data available in Health, United States, the annual report on the health of the nation submitted by the Secretary of the Department of Health and Human Services to the President and Congress.

Each Spotlight displays approximately four health indicators allowing users to visualize and interpret complex information from different data systems and Health, United States subject areas.

This infographic features indicators from the report’s Health Care Expenditures & Payers subject area.

The full Health, United States reports are available at:http://www.cdc.gov/nchs/hus.htm