Selected Health Conditions Among Native Hawaiian and Pacific Islander Adults: United States, 2014

March 15, 2017

Questions for Adena M. Galinsky, Statistician and Lead Author on “Selected Health Conditions Among Native Hawaiian and Pacific Islander Adults: United States, 2014

Q: What factors led you to undertake this analysis on Native Hawaiian/Pacific Islanders?

AG: NHPI became a race group separate from Asians nearly 20 years ago, but there are still few reliable national NHPI health statistics, because the population is numerically small and hard to include in sufficient numbers in national health surveys.

While NCHS as an agency is committed to collecting and reporting health information about all Americans, our goal with this new survey is to fill the gaps in the country’s knowledge about the health of Native Hawaiian and Pacific Islanders in the United States so that others can make decisions based on accurate, reliable, up to date information.

This research is just the beginning of the exciting work that will be coming out using this data.


Q: What do you feel was the most interesting finding in the study?

AG: The pattern of results was the most interesting finding: that for a whole range of outcomes, from serious psychological distress, to arthritis, to asthma, the NHPI population had a higher prevalence than the Asian population.


Q: Is there any comparable data at the moment? Have there been any other studies done on this population and if so, what conclusions were drawn from those studies?

AG: The annual National Health Interview Survey (NHIS) has been publishing NHPI statistics for a while now (since 2003, when data from the 1999 NHIS were published), but because of small sample sizes many of the statistics were unreliable, and not useful for comparing to other populations’ statistics, such as Asian. A few NHPI statistics have been reliable over the years, such as the high prevalence of diabetes in the NHPI population. But trend data has been hard to come by, because even when an NHPI statistic for a given health condition is reliable one year, it’s generally unreliable or suppressed the next.


Q: So the bottom line here is that NHPIs are in poorer health than the U.S. population as a whole?

AG: That’s suggested here but it’s not really the bottom line. The bottom line here is that the NHPI population differs in many ways from the Asian population, and any analysis that presents combined API statistics will likely only tell the story of the Asian population, since that population is so much larger.

Also, it’s crucial that more work is done using the data file that was just released today. This data source is unprecedented and will allow a much more thorough understanding of the health of the NHPI population. We plan to do more research and we are hopeful that many researchers will do the same.


Q: Why would this population lag behind the rest of the population in certain health indicators?

AG: The data in this report do not address that. Other research has shown that there are socioeconomic differences between the NHPI population and the rest of the population. But our report does not answer this question.


Q: Why is it important to compare this group to single-race Asian adults?

AG: The NHPI population has traditionally been subsumed into the “Asian and Pacific Islander” category. The Asian population is much larger than the NHPI population and the question has been whether API statistics were really telling the story of both the Asian and NHPI population, or just the Asian population.

Of course, even within the Asian population there is variation/heterogeneity, but these results, which show the pattern of differences between the NHPI and Asian populations illustrate the danger of assuming that statistics that describe the Asian population also describe the NHPI population.


Utilization of Clinical Preventive Services for Cancer and Heart Disease Among Insured Adults: United States, 2015

March 8, 2017

Questions for Anjel Vahratian, Supervisory Statistician (Health) and Lead Author on “Utilization of Clinical Preventive Services for Cancer and Heart Disease Among Insured Adults: United States, 2015

Q: Why did you decide to look at clinical preventive services for cancer and heart disease among insured adults?

AV: Heart disease and cancer are the top two leading causes of death in the United States. The clinical preventive services discussed in this report are recommended for the prevention or early detection of heart disease and cancer. We limited our analysis to insured adults because most insurance plans were required to cover these clinical preventive services without co-payment from the insured adult in 2015.


Q: What did your report find out about cancer screenings among insured adults?

AV: In 2015, two-thirds of insured adults aged 50-75 were screened for colorectal cancer within the recommended intervals, and screening was significantly associated with age for both men and women. Insured women aged 50-59 were more likely to be screened for colorectal cancer compared with men of the same age. Among insured women, more than 8 out of 10 of those aged 21-65 had been screened for cervical cancer, and nearly 3 out of 4 of those aged 50-74 had been screened for breast cancer within the recommended intervals.


Q: What did your report find out about heart disease screenings among insured adults?

AV: In 2015, more than 8 in 10 insured adults aged 18 and over had their blood pressure checked by a doctor or other health professional, and about 2 in 3 overweight and obese insured adults aged 40-70 had a fasting blood test for high blood sugar or diabetes in the past 12 months. Receipt of these services increased with advancing age and varied by sex. Insured women aged 18-39 and 40-64 were more likely than their male peers to have their blood pressure checked in the past 12 months, and insured overweight and obese women aged 40-49 were more likely than men of the same age and BMI to have a fasting blood test or diabetes in the past 12 months.


Q: Was there a specific finding that you found surprising?

AV: It was surprising that only 49.5% of overweight and obese insured men aged 40-49 had a fasting blood test for diabetes in the past 12 months. Diabetic adults are at increased risk of developing cardiovascular disease, and overweight and obesity and abnormal blood glucose are modifiable cardiovascular risk factors.


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

AV: Utilization of clinical preventive services aimed at the early detection of cancer and cardiovascular disease varied by sex and age among insured adults. Insured adults in their 40s and 50s were less likely than those in their 60s to be screened for colorectal cancer, high blood pressure, and diabetes. Limited knowledge about the recommendations for clinical preventive services may prevent eligible adults from seeking out timely preventive care.


QuickStats: Age-Adjusted Percentage of Adults Aged 65 Years or Older by Number of 10 Selected Diagnosed Chronic Conditions and Poverty Status

February 27, 2017

For the period 2013–2015, 13% of adults aged 65 years or older reported having none of 10 selected diagnosed chronic conditions; 25% had one, 46% had two or three, and 16% had four or more of the conditions.

No differences by poverty status were observed among those who reported having two or three conditions, but those in the lowest income group (100% or less of the poverty threshold) were less likely to have none or only one of the chronic conditions compared with those in the highest income group (400% or more of the poverty threshold).

Those in the lowest income group also were more likely to have four or more conditions when compared with those in the highest income group (21% compared with 12%).

Source: https://www.cdc.gov/mmwr/volumes/66/wr/mm6607a6.htm


Early Release of Selected Estimates Based on Data From the January–September 2016 National Health Interview Survey

February 23, 2017
Tainya C. Clarke, Ph.D., M.P.H., Health Statistician

Tainya C. Clarke, Ph.D., M.P.H., Health Statistician

Questions for Tainya C. Clarke, Ph.D., M.P.H., Health Statistician and Lead Author on the “Early Release of Selected Estimates Based on Data From the January–September 2016 National Health Interview Survey.”

Q: What health measures does this report look at?

TC: The measures covered in this report are lack of health insurance coverage and type of coverage, having a usual place to go for medical care, obtaining needed medical care, receipt of influenza vaccination, receipt of pneumococcal vaccination, obesity, leisure–time physical activity, current cigarette smoking, alcohol consumption, human immunodeficiency virus (HIV) testing, general health status, personal care needs, serious psychological distress, diagnosed diabetes, and asthma episodes and current asthma. Three of these measures (lack of health insurance coverage, leisure-time physical activity, and current cigarette smoking) are directly related to Healthy People 2020 Leading Health Indicators.


Q: How do you collect your data for these surveys?

TC: The data is collected by household interview surveys that are fielded continuously throughout the year by the National Center for Health Statistics (NCHS). Interviews are conducted in respondents’ homes. Health and socio-demographic information is collected on each member of all families residing within a sampled household. Within each family, additional information is collected from one randomly selected adult (the “sample adult”) aged 18 years or older and one randomly selected child (the “sample child”) aged 17 years or younger. NHIS data is collected at one point in time so we cannot determine causation. Data presented in this report are quarterly data and are preliminary.


Q: What are some of the findings that you would highlight in this early release report?

TC: Here are some findings from the early release report:

• The percentage of persons of all ages who had a usual place to go for medical care decreased, from 87.9% in 2003 to 85.4% in 2010, and then increased to 88.3% in January–September 2016.

• The percentage of persons who failed to obtain needed medical care due to cost increased, from 4.3% in 1999 to 6.9% in 2009 and 2010, and then decreased to 4.4% in January–September 2016.

• The percentage of adults aged 65 and over who had ever received a pneumococcal vaccination increased from 63.5% in 2015 to 67.3% in January–September 2016.

• The prevalence of obesity among U.S. adults aged 20 and over increased, from 19.4% in 1997 to 30.6% in January–September 2016.

• In the third quarter of 2016, 52.8% of U.S. adults aged 18 and over met the 2008 federal physical activity guidelines for aerobic activity (based on leisure-time activity). This was higher than the third quarter of 2015 estimate of 49.5%.

• The prevalence of current cigarette smoking among U.S. adults declined, from 24.7% in 1997 to 15.3% in 2015 and remained low through the third quarter of 2016 (15.9%).
• During January–September 2016, men were more likely to have had at least 1 heavy alcohol drinking day (31.6%) in the past year compared with women (18.6%).

• The prevalence of diagnosed diabetes among adults aged 18 and over increased, from 5.1% in 1997 to 9.2% in 2010, and has since remained stable through January–September 2016.


Q: What do the findings in this report tell us about the health of the country overall?

TC: Since 2010, the percentage of uninsured persons has decreased by almost 50% (16.0% vs 8.8%) and the percentage of persons who failed to obtain needed medical care due to cost has also shown a significant decline during the same time period (6.9% to 4.4%). These two indicators demonstrate increased access to healthcare from 2010 to September 2016.


Q: Are there any trends in this report that Americans should be concerned about?

TC: Although in the 3rd quarter of 2016, 52.8% of U.S. adults met the 2008 federal physical activity guidelines for aerobic activity; obesity is an epidemic that has seen a steady increase since 1997 and now affects just under one third (30.6%) of U.S. adults.


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.


The Association of Marital Status and Offers of Employer-based Health Insurance for Employed Women Aged 27–64: United States, 2014–2015

January 12, 2017

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “The Association of Marital Status and Offers of Employer-based Health Insurance for Employed Women Aged 27–64: United States, 2014–2015

Q: Why did you decide to do a report comparing the marital status and offers of employer-based health insurance for employed women?

RC: A recent study found that women were less likely than men to have been insured through own employer and more likely to have been covered as a dependent. This report describes the association of marital status and the presence of employment-based insurance offers among employed women in the United States. It is important to note, that the presence of an offer does not necessarily indicated take-up.


Q: Is this the first time the National Health Interview Survey (NHIS) has released a report on this topic? If not, where is trend data available?

RC: This is the first time that NHIS has released a report on the association of marital status and of offers of employer-based private health insurance coverage for employed women.


Q: In general, how do offers of employer-based health insurance for employed women vary by marital status?

RC: Marital status is an important predictor of having an offer of health insurance through employment for employed women aged 27-64. Married women may gain an additional opportunity for an offer of health insurance coverage through their spouse’s employer. Therefore, taking all offers of health insurance into account, employed married women aged 27-64 were more likely than employed unmarried women to have an employer offer of health insurance.


Q: How do offers of employer-based health insurance vary by marital status for employed women within categories of educational attainment?

RC: Regardless of educational attainment, employed married women aged 27-64 were more likely than employed unmarried women to have been offered health insurance by their employer or their spouse’s employer. For both married and unmarried women, total health insurance offers increased as levels of educational attainment increased.


Q: Do offers of employer-based health insurance vary by marital status for employed women aged within categories of race and ethnicity?

RC: Employed non-Hispanic white and non-Hispanic Asian unmarried women were more likely than their married counterparts to have an offer of coverage from their own employer. However unmarried Hispanic and non-Hispanic black women were about as likely to have an offer of coverage from their own employer.


QuickStats: Percentage of Adults Who Are Very Worried about Medical Costs, by Home Ownership and Age Group

January 4, 2017

In 2015, 15.6% of adults who lived in rental houses/apartments were very worried about paying for medical costs, compared with 8.7% of adults who lived in family-owned homes.

Adults aged 18–39 years who lived in rental homes were more likely than those in family-owned homes to be very worried about paying medical costs (12.9% versus 8.0%).

Among adults aged 40–64 years and 65 years or older, renters were twice as likely as home owners to be very worried about medical costs (22.3% versus 11.4%, and 8.6% versus 4.0%, respectively).

Source: https://www.cdc.gov/mmwr/volumes/65/wr/mm655051a7.htm