Vision testing among children aged 3-5 years in the United States, 2016-2017

November 20, 2019

Questions for Lindsey Black, M.P.H., Health Statistician and Lead Author of “Vision testing among children aged 3-5 years in the United States, 2016-2017

Q: Why did you decide to focus on vision testing for children aged 3-5?

LB: Over a quarter of all children aged 0-17 years have vision problems (1). Two common eye problems, amblyopia (lazy eye) and strabismus (crossed eyes) can be treated and prevent further vision problems if they are found early (2). The USPSTF recommends children between 3-5 years old have vision screening (3) and Healthy People 2020 target for vision screening is 44.1% of preschool aged children (1). Despite this, little is known about the current prevalence of vision screening and how this may differ by population subgroups. We focused on children 3-5 years old as they are the focus of the USPSTF recommendations.

  1. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Accessed at : https://www.healthypeople.gov/2020/topics-objectives/topic/vision/objectives
  2. Office of Disease Prevention and Health Promotion. Get your child’s vision checked. Washington DC. Accessed at: https://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-your-childs-vision-checked
  3. US Preventive Services Task Force. Vision Screening for Children 1 to 5 Years of Age: US Preventive Services Task Force Recommendation Statement. Pediatrics 127, 2 p340

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

LB: Overall, as children aged, they were more likely to have ever had their vision tested. Additionally, as children aged, they were also more likely to have had their vision tested in the past 12 months. There was also variation by race and Hispanic origin. About 65% of Non-Hispanic white children, 63% of non-Hispanic black children and 59% of Hispanic children have ever had their vision tested. Children with private health insurance (66.7%) were most likely to have ever had their vision tested compared with children with public insurance (61.2%) and children who are uninsured (43.3%).


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

LB: It was surprising how much of an impact a recent well-child visit had on ever having a vision test. Children who did not receive a well-child visit in the past 12 months (44.1%) were less likely to have ever had their vision tested when compared to children that had received a well-child visit in the past 12 months (65.9%). Since vision screenings are recommended to be part of well-child visits, these visits provide valuable opportunities to detect problems and offer intervention efforts.


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

LB: Data are from the pooled 2016-2017 National Health Interview Survey and can be accessed via: https://www.cdc.gov/nchs/nhis.htm. Questions on vision testing are from supplement questions, which focused on expanded content related to child vision. This supplement was asked most recently in 2016-2017.


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

LB: Approximately 64% of children aged 3-5 have ever had their vision tested by a doctor or other health professional. As children age, they are more likely to have had their vision tested. Disparities exist by race, and health insurance status. Receipt of a recent well-child visit was also associated with a higher prevalence of receiving a vision test.

 


QuickStats: Percentage of Adults Aged 25 Years or Older Who Had Seen a Health Care Professional in the Past 12 Months and Who Easily Understood Information from Their Health Care Providers Most or All of the Time by Sex and Education Level

November 15, 2019

In 2017, 91.6% of adults aged 25 years or older easily understood information from their health care providers most or all of the time.

The percentage of adults who easily understood health care information most or all of the time increased as education level increased.

Adults who had completed a bachelor’s degree or higher were the most likely to understand their health care providers at least most of the time (93.9%), whereas those without a high school diploma were the least likely (85.2%).

Men (91.0%) were somewhat less likely than women (92.1%) to have easily understood information from providers most or all of the time.

Source: National Health Interview Survey, 2017. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6845a6.htm


QuickStats: Percentage of Adults Aged 18 Years or Older Who Did Not Take Their Medication as Prescribed or Asked for Lower-Cost Medication to Save Money Among Those Prescribed Medication in the Past 12 Months by Number of Chronic Conditions

November 1, 2019

In 2018, among adults aged 18 years or older who were prescribed medication in the past 12 months, the percentage who did not take their medication as prescribed to save money increased with the number of reported chronic conditions, from 6.2% with no chronic conditions to 9.1% with 1–2 chronic conditions and 14.0% with more than 3 chronic conditions.

The percentage who asked their doctor for a lower-cost medication also increased with the number of reported chronic conditions from 15.1% among those with no chronic conditions to 18.4% among those with 1–2 chronic conditions and 27.4% among those with more than 3 chronic conditions.

Source: National Health Interview Survey, 2018 data. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6843a6.htm


QuickStats: Age-Adjusted Percentages of Adults Aged 18–64 Years Who Never Felt Rested in the Past Week by Sex, Race, and Hispanic Origin — National Health Interview Survey, 2017–2018

October 25, 2019

During 2017–2018, among persons aged 18–64 years, women were more likely than men to report they never felt rested in the past week overall (21.1% versus 14.3%) and in each race and Hispanic origin group.

Non-Hispanic white men (16.0%) were more likely to report they never felt rested than were Hispanic men (11.1%), non-Hispanic black men (12.0%), and non-Hispanic Asian men (9.7%).

Non-Hispanic white women (23.0%) were more likely to report they never felt rested than were Hispanic women (19.0%), non-Hispanic black women (18.9%), and non-Hispanic Asian women (13.7%).

Source: National Center for Health Statistics, National Health Interview Survey, 2017–2018. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6842a4.htm 


QuickStats: Percentage of Women Aged 50 Years or Older Who Have Had a Hysterectomy, by Race/Ethnicity and Year — National Health Interview Survey, United States, 2008 and 2018

October 18, 2019

The percentage of women aged 50 years or older who have had a hysterectomy decreased from 36.6% in 2008 to 31.7% in 2018.

Decreases were also observed among non-Hispanic white women (37.5% to 33.3%) and Hispanic women (30.3% to 22.6%), but there was no significant decrease for non-Hispanic black women (40.4% to 36.8%).

For both time points, non-Hispanic black and non-Hispanic white women were more likely than Hispanic women to have had a hysterectomy.

Source: National Health Interview Survey, 2008 and 2018 data. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6841a3.htm


Breast Cancer Screening Among Women by Nativity, Birthplace, and Length of Time in the United States

October 9, 2019

Questions for Lead Author Tainya Clarke, Health Statistician, of “Breast Cancer Screening Among Women by Nativity, Birthplace, and Length of Time in the United States.”

Q: Why did you decide to do a report on mammography screening among women by nativity?

TC: There is currently limited published research on how nativity, birthplace and/or lifetime in the US of ethnically diverse foreign-born women affect the likelihood of having a mammogram.


Q: How did the data vary by nativity, birthplace and lifetimes in the United States?

TC: Foreign-born women were less likely than US-born women to have ever had a mammogram. If evaluated on equal standing for selected sociodemographic factors e.g. income, education, marital status; foreign-born women residing in the United States for less than 25% of their lifetime were as likely as US-born women to have met the U.S. Preventive Services Task Force (USPSTF) recommendations, while those residing in the United States for 25% or more of their lifetime were more likely to do so than US-born women.


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

TC: Yes, we found that after controlling for the sociodemographic factors examined in this research, foreign-born women from some countries such as Mexico, and Central America were more likely to have received mammogram compared with US-born women.


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

TC: The data was obtained from the National Center for Health Statistics NCHS and most of the information used are publicly available. Information such as country of birth and year of immigration may be obtained through the CDC’s Research Data Center (RDC) by submitting a proposal stating the reason for use.


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

TC: Length of lifetime in the US among foreign-born women have some positive affect on the likelihood of having a mammogram among foreign-born women. However, analyses indicate that the absence of some sociodemographic factors such as health insurance coverage, usual place for medical care, and poor standing in some factors such as educational attainment, seeing a doctor in the past year and income, also play a role in the likelihood of getting a mammogram among foreign-born women.


Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity

October 8, 2019

 

Questions for Emily P. Terlizzi, M.P.H., Lead Author on “Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity

Q: Why did you choose to look at this topic?

ET: As we mention in the report, the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care, or the CLAS standards, were released from OMH in order to provide guidance to health care organizations in order to practice more culturally competent care. Previously though, there weren’t a lot of sources of nationally representative data to measure progress towards these standards. So to address this, there were several questions added to the NHIS in 2017 about patients’ perceptions of cultural competence of their health care providers. This report takes a look at two of these questions, and is one of few which provides nationally representative data on perceptions of cultural competence in the health care setting.


Q: How do you measure how well a provider “understands” their patient’s culture?

ET: The questions asked on the NHIS that are analyzed in this report are asking about patient’s perceptions of their providers. The question asks “Some people think it is important for their providers to understand or share their race or ethnicity or gender or religion or beliefs or native language. How important is it to you that your health care providers understand or are similar to you in any of these ways? Would you say… very important, somewhat important, slightly important, or not important at all”? We don’t know specifically what the respondents were thinking of when they answered these questions, just what they were asked and how they answered.


Q: What were some of the more interesting findings you uncovered?

ET: Among adults who had seen a health care professional in the past 12 months, the percentage of non-Hispanic white adults who thought it was very important to have a health care provider who shared or understood their culture was significantly lower than that among all other race and Hispanic-ethnicity groups. Among those who thought it was at least slightly important to have a health care provider who shared or understood their culture, minority groups were generally more likely to report never being able to see a culturally similar health care provider compared with non-Hispanic white adults, and this pattern persisted regardless of sex, age group, or urbanicity.


Q: So would you say that the “lack of understanding” or sharing of culture is a problem in the U.S.?

ET: I can’t speak to the implications of these findings, but what I can say is that per our 2017 data, there are racial and ethnic differences in reported importance and access to health care providers who share or understand their culture.


Q: What will this information do to improve health care quality in the U.S.?

ET: This study examined racial and ethnic differences in patients’ perceptions of the importance and frequency of seeing providers who share or understand their cultural characteristics. Our study isn’t looking at the effects on health care quality, but is just the start of measuring progress towards the CLAS standards.


Q: Any other things about this study that you’d like people to be aware of?

A: I think the take home message of the report is that racial and ethnic minorities were more likely to find it important that their provider share or understand their culture, but were less likely to be able to see a provider who met these criteria.